ORAL ANSWERS TO QUESTIONS

COMMUNITIES AND LOCAL GOVERNMENT

The Secretary of State was asked-

Planning Appeals

Laurence Robertson: Under what exceptional circumstances planning inspectors may consider representations on planning appeals made after the deadline for submissions has passed.

John Healey: Information can be accepted after the deadline when there has been a material change in circumstances or when there are demonstrably good reasons for the deadline to have been missed.

Laurence Robertson: I am grateful to the Minister for that response and for his earlier telephone call to my office. He will be aware that, in a planning appeal in Innsworth in my constituency, although the public inquiry date has passed and the inquiry has finished, a change of details has been submitted by the developer. A rather confusing letter from the Secretary of State's office purports to reopen the inquiry, but surely that cannot be an open and transparent way of dealing with planning applications. Will the Minister look into this issue further?

John Healey: The material change of circumstances in that case was the offer from the developer, after the inquiry, to increase the proportion of affordable housing in the proposals-something that I would have assumed that the hon. Gentleman welcomes. Clearly, it would have been wrong if the Secretary of State had not then sought the views of the parties at the inquiry to that change in the proposals. My right hon. Friend the Secretary of State has acted openly and done the right thing in seeking those views. He is currently considering the case carefully.

Efficiency Savings

Mark Hendrick: What guidance he has issued to local authorities on achieving efficiency savings without reducing front-line services.

John Denham: I asked an expert taskforce, chaired by Sir Steve Bullock, mayor of Lewisham, and Sir Richard Leese, leader of Manchester city council, to look at how best to achieve efficiency savings and protect front-line services. Their report "Putting the Frontline First: Meeting the local government challenge" was published on 1 March. It sets out 10 decisive steps that councils can take to achieve efficiency while delivering high-quality local services. Local people will rightly be intolerant of any council if they are told that front-line services like care provision, libraries or youth services will be cut because it has failed to carry through all the recommendations made in our experts' taskforce report.

Mark Hendrick: Will my right hon. Friend comment on the disgraceful situation at the now Conservative-led Lancashire county council? It has received a 5.1 per cent. increase in Government grant but has cut the budget by 3 per cent., with the likelihood that 200 to 300 jobs will now be lost. The council is also failing to support the staff at the National Football museum who need an agreement to be reached between Lancashire county council and Manchester city council so that the museum can remain at Preston and in Manchester as well.

John Denham: First, may I pay tribute to my hon. Friend's sterling efforts to support the football museum and to retain it for his constituency? He makes an important wider point, because some local authorities are trying to suggest that the cuts that they are making to front-line services in some way reflect cuts in central Government finance or the wider economic circumstances. As he has rightly highlighted, English local authorities received, on average, a 4 per cent. cash increase for the coming year, and the cuts that are being made reflect the decisions of Tory and Liberal local authorities to make them at a local level.

Greg Hands: Will the Secretary of State join me in congratulating Hammersmith and Fulham council on delivering a council tax cut for the fourth year in a row while preserving its four-star quality rating for services? Will he also use this occasion to apologise to the leader of the council for saying that the leader had allegedly said of council tenants, "These people are hard to shift"? That is totally and utterly untrue, and it is time that the right hon. Gentleman apologised for that mis-statement.

John Denham: I prefer the records of the eight Labour London local authorities that have frozen council tax while protecting front-line services. He will be aware of the impact of local decisions to raise charges for elderly people and of housing strategies that seem to be designed to deny security of tenure to people who have long enjoyed secure local housing. I do not share his assessment of his local authority's record-indeed, far from it; I think it is a warning that should be broadcast to tenants up and down the country, and I will do my very best to make sure that it is.

Alan Whitehead: Ryanair was recently voted the least family- friendly company in the country. In the light of that, what is my right hon. Friend's view of local authorities that seek to make efficiency savings by instituting two-tier services, with a no-frills basic?

John Denham: I worry greatly about councils that are proposing what they call a budget-airline or Ryanair approach to local government, with services stripped down to the most basic level. The only people who enjoy decent services are those who can afford to pay for them twice-once through the council tax, and once through charges. For example, I was told the other day that Wolverhampton council has made it part of its standing orders that every service should be charged at a full-cost recovery rate, unless specifically authorised otherwise by a cabinet member.
	I think that that approach will leave large numbers of people on middle incomes unable to enjoy decent council services. It is a shame that it is being championed by the Opposition.

Julia Goldsworthy: The Secretary of State seems very keen to talk about this year's Budget settlement, but less keen to talk about Government grants looking ahead. What guidance has he received from the Treasury about the scale of future cuts that councils will need to make? Does he really believe that efficiencies alone will be able to halve the deficit?

John Denham: I certainly believe that the budget reduction programme set out by my right hon. Friend the Chancellor of the Exchequer in the pre-Budget report is a credible one. It can be delivered in local government without damaging front-line services, provided that the hard decisions are taken to deliver efficiencies. My Department set out in the PBR where we expect savings to be made through operational efficiency and through savings on particular local government services. That can be done so that members of the public see their services protected and improved where they use them.

Julia Goldsworthy: The problem is that the Institute for Fiscal Studies thinks that that is simply not possible, and that deep cuts will follow in years ahead. Given that no credible detail is forthcoming from either the Government or those on the Conservative Front Bench, should the right hon. Gentleman not be doing the responsible thing and advising councils to prepare for the worst-case scenario pointed out by the IFS-that is, reductions of up 23 per cent. over four years from 2011?

John Denham: The hon. Lady is wrong on both counts. In reply to an earlier question, I said that we have published a report from two respected local government leaders on precisely the measures that local government should be planning to take now to make the most efficient use of the available resources. As the House knows, however, the reality is that there has not yet been a comprehensive spending review for the next three-year settlement because we have been through a year of the most extraordinary economic change. The policies that we have implemented have seen the Government, the country and local government through the crisis, because we rejected the calls from the Opposition to cut our spending last year. It would have been irresponsible to try to project exact levels of spending for four years from today, given the uncertainties of the past year. Clearly, spending plans will have to be set out, but the timing is a matter for my right hon. Friend the Chancellor of the Exchequer.

Richard Burden: Given the levels of support that Birmingham city council has had from the Government over the past decade, why does my right hon. Friend feel that it has got itself into such a financial mess, to the extent that thousands of jobs are threatened and services to the public are being put at risk?

John Denham: I can understand the concern of my hon. Friend and other Birmingham Members of Parliament. It is true that Birmingham has not received the highest rating, shall we say, from the Audit Commission, for the quality of its financial management. The record shows that it has been given resources by the Government for tackling worklessness, but that it has failed to devote them to tackling that problem. It is a shame that Birmingham's Conservative-Liberal Democrat council is saying that front-line services will have to go, when issues about how the council manages its resources clearly need to be addressed closer to home.

Caroline Spelman: Instead of shamelessly scaremongering, it would have been nice if the Secretary of State had acknowledged that local government has already had considerable success in delivering efficiency savings. Can he understand why councils feel so furious about being instructed to meet the £250 million shortfall in the Prime Minister's latest commitment to personal care? The Government define a new burden as
	"any new policy or initiative which increases the cost of providing local authority services."
	Will he explain which part of that £250 million is not covered by that doctrine?

John Denham: It is a shame that the hon. Lady has not welcomed the fact that the Prime Minister's proposals for free care at home for those with the highest needs involve the biggest single transfer of resources from the NHS to local government since the NHS was founded in 1948. It is a massive vote of confidence in the ability of local government to deliver the policy. I believe that the savings that local government is being asked to make can be achieved. As she herself has said, local government has proved its ability to make efficiency savings and to plough them into other front-line services.

Caroline Spelman: We all want to see help for those who most need it. The question is where the money is coming from. The Government must be living in cloud cuckoo land if they believe that the £250 million bill for changes in personal care does not fall under the definition of an unfunded burden. Is it not the case that the efficiency savings earmarked for that policy will not materialise until 2012-13, yet the policy comes into force this year? Can the Minister explain to the House where the shortfall will be found, and whether the figure of £250 million is capped? If not, is it not the case that as well as being unfunded, the policy is uncosted?

Mr. Speaker: Order. There were three questions, but one answer from the Secretary of State will suffice.

John Denham: In which case, Mr. Speaker, I will respond to the point that we all want to do something to help. I recall that when cross-party talks were taking place in an attempt to establish a consensus on social care, it was the Conservative party which broke out of those in order to launch a cheap-shot poster campaign, rather than try to address the serious issues that concern elderly people in this country.

Regional Regeneration

Tony Lloyd: What recent assessment he has made of the effectiveness of Government support for local authority regeneration initiatives delivered regionally.

Rosie Winterton: An independent report by PricewaterhouseCoopers published in March 2009 established that, on average, every £1 of regional development agency spend, much of which is in partnership with local authorities, will add on average £4.50 of value to their region. The PWC report found that in the Northwest regional development agency area, 41,000 jobs were created or safeguarded, 8,000 businesses were assisted and 48,000 people were helped with training.

Tony Lloyd: Those figures are impressive. Does it not beggar belief that there are those who cannot make up their mind what they should do with regional development agencies, which have been such a great success in regenerating and creating employment in the north-west of England?

Rosie Winterton: My hon. Friend is right. As somebody who meets a number of businesses, I know that they are horrified by the idea that any Government or potential Government would talk about abolishing the regional development agencies. That is the view not only of businesses, but of business organisations such as the Engineering Employers Federation, the CBI and the chambers of commerce. However, I notice that the hon. Member for Meriden (Mrs. Spelman) and the right hon. and learned Member for Rushcliffe (Mr. Clarke) have now written down their policy, in a vague attempt to see if it will last longer than one day.

Mr. Speaker: I am grateful to the right hon. Lady, but we want to hear about Government policy.

Caroline Spelman: Last Friday's edition of Property Week condemned the Government's track record on regeneration by pointing out that the pathfinder scheme has been responsible for the demolition of more than 16,000 homes, yet has created only 3,700 new homes, with a net loss of 12,000 homes. In short, the scheme has cost £2.2 billion and knocked down four times as many homes as it created. Does the Minister regard that as a success?

Rosie Winterton: As I understand it, for the scheme to which the hon. Lady refers, the expenditure so far has been on acquiring the land. It will continue. The Government are looking at ways in which we can intervene in the economy at local, regional and national level to address the problems that have arisen during the economic downturn. The Opposition have a hands-off, "don't care" attitude to regeneration and economic development.

Clive Betts: I know that my right hon. Friend is well aware that the public railway in the centre of Sheffield has been transformed by the actions of the then Labour-controlled city council and Yorkshire Forward working together. She is probably also aware that at a Regional Select Committee hearing recently, every employers body that came to give evidence praised the actions of Yorkshire Forward in helping its members in the recession. For both those reasons, would it not be folly to get rid of Yorkshire Forward and other RDAs, particularly at this time of economic difficulty?

Rosie Winterton: My hon. Friend is absolutely right, and as the Minister for Yorkshire and the Humber I know also how much Yorkshire Forward is valued in terms of the work that it has done. At this point, even talking about removing that help sends completely the wrong message to businesses, because we can put together assistance to help people through into the recovery. For the Opposition to talk about dismantling that help is a very bad approach.

House Building Projects

Paul Rowen: What account his Department takes of the effects on local employment in the construction industry in its decisions on the allocation of funding for house building projects.

Greg Mulholland: What account his Department takes of the effects on local employment in the construction industry in its decisions on the allocation of funding for house building projects.

Ian Austin: In September 2009 we announced that all new housing projects funded with public investment will be required to offer apprenticeships and local labour opportunities. The aim of that policy is to increase opportunities for young and unemployed people who have been particularly hard hit in the current economic climate.

Paul Rowen: I understand that, but I am sure that the Minister is aware that there are 750,000 empty homes, and that more than 200,000 construction workers are chasing 300 jobs. Does he not accept, therefore, that the Government ought to do more to bring empty homes back into use?

Ian Austin: It is precisely because we want to do more in the housing industry that we have announced the £1.5 billion housing pledge to increase the number of homes being developed and to provide jobs in construction.

Greg Mulholland: The Minister completely failed to answer the previous question. In Otley, in my constituency, we lost Lotus Construction last year, with the loss of 80 jobs-an experience common to many constituencies. Considering that on average it costs £10,000 to bring an existing property back into use, compared with £100,000 for a new social house, how can the Minister possibly say that the Government are doing enough to bring homes back into use?

Ian Austin: We are investing money in improving existing properties, as well as in building new ones. This Government's record in supporting the construction industry through the downturn has been absolutely first-class. This has been the first recession in which a Government have invested record amounts to keep the economy moving, protect jobs in construction and provide the skills that the industry will need in the future.

Phyllis Starkey: The Government have given Milton Keynes council funding to appoint an officer to start implementing the empty dwelling management order, because the Liberal Democrat-controlled council has done absolutely nothing on it for the past three years, despite the fact that I went to it with lists of empty properties that were prime candidates for the order. Does the Minister agree, however, that house building is required to meet housing need, and that empty homes, although important, are a flea bite compared with the breadth of housing need in places such as Milton Keynes?

Ian Austin: My hon. Friend is absolutely right about the need to build more homes, and that is why we are investing record amounts in the house building industry. She is also absolutely right also about empty homes, and I congratulate her on her work in Milton Keynes to ensure that they are brought back into use.

Gerald Kaufman: Will my hon. Friend welcome the programme, which will create many jobs, to bring 5,300 socially rented homes in my constituency up to and beyond the Government's decent homes standard, with new kitchens and bathrooms, rewiring, new boilers- [ Interruption. ]-windows and doors, roofing, chimney repairs, repointing and insulation works? Is not that a good record for a Labour Government and a Labour council?

Ian Austin: That is a very good record, and the Opposition were interjecting because they do not value that investment in improving homes for ordinary people. I welcome what my right hon. Friend says. Once again he has demonstrated the faultless judgment that he has exercised over a lifetime's public service.

Grant Shapps: This is the fourth Housing Minister whom I have faced over the Dispatch Box, but I congratulate him on having, this weekend, outlasted at least his immediate predecessor, the right hon. Member for Derby, South (Margaret Beckett).
	Today, the Library confirmed that house building has fallen to its lowest level, excluding the war years, since 1924, when Ramsay MacDonald became Prime Minister. Is that damning indictment of Labour housing policy a result of the record nine different Housing Ministers, or of Labour's obstinate refusal to work alongside local people to build more homes?

Ian Austin: What complete and utter nonsense. The answer is neither of those reasons. The level has fallen to its lowest level because-the hon. Gentleman may not have noticed this-we have just been through the most extraordinary recession that this country and the world have ever seen. That is why we have invested £1.5 billion this year and next to build 20,000 new affordable homes-investment opposed by the Opposition. Building work has started on more than 80 kickstart projects; the first homes in more than a decade are being built under the local authority new build scheme; and residents in those areas-the families who are desperate to get a home-as well as construction workers and building companies, too, want to know why the Opposition want to cut that spending this year and next and put all those jobs at risk.

Unitary Authorities (Essex)

Bob Russell: If he will arrange for public consultation to take place in Essex on the subject of establishing unitary authorities.

Barbara Follett: The statutory process for establishing unitary authorities requires a council to make a unitary proposal in response to an invitation from the Secretary of State, and does not provide for any public consultation in advance of such an invitation.

Bob Russell: I invite the Minister to extend that invitation to Colchester borough council without further ado, because Essex county council is an appalling local authority which should be abolished. May I advise her that, as I told one of her colleagues last year, surveys in Colchester show that 75 per cent. of the population wish to break away from Tory-controlled county hall because, as the only local authority in Essex not run by the Conservatives, my local council suffers political discrimination from the Conservatives at county hall?

Barbara Follett: As Minister for the East of England, I understand exactly what the hon. Gentleman is saying, and I would advise him to get Colchester council to request the Secretary of State to make such an invitation. I know that the hon. Gentleman has met the Minister for Regional Economic Development and Co-ordination about this, and I understand his concerns well.

Mr. Speaker: Order. I want to make much sharper progress down the Order Paper from now on. I call Mr. Jim Cunningham.

Local Authorities (Recession)

Jim Cunningham: What recent representations he has had from local authorities on the effects on them of the recent recession.

Barbara Follett: My Department is in regular dialogue with local authorities about the impact of the current economic climate and the commendable measures that most councils are taking to ameliorate this. Their efforts have been helped by above-inflation funding increases from central Government to local authorities overall.

Jim Cunningham: I will be very quick, Mr. Speaker. Can the Minister tell me what the financial impact will be on social cohesion?

Barbara Follett: Fortunately, the impact on social cohesion has been less than it was in previous recessions in the previous century. In fact, certain statistics such as crime figures have fallen by 8 per cent., whereas in the previous recession they went up by 19 per cent.

Unitary Authority (Norfolk)

Chloe Smith: For what reasons he overruled the advice of his Department's accounting officer in relation to the value for money of his proposals for unitary restructuring in Norfolk.

John Denham: Following the end of the consultation on 19 January, Ministers gave careful consideration to the boundary committee's advice, the representations we had received, and all other relevant information, including the advice from the permanent secretary. While expressing concern that our proposed approach would impact adversely on the financial position of the public sector as compared with the alternative options available to us, he highlighted the savings that would be achieved by the unitary Norfolk and unitary Devon proposed by the boundary committee.
	We had previously been consistently advised that we were not duty bound to choose the cheapest option. We noted that the unitary county option did not command the support of any of the principal councils, including Norfolk county council and Devon county council, and we were reluctant to pursue recommendations that did not meet the broad cross-section of support criteria. We concluded that a unitary Exeter and a unitary Norwich which were locally supported was the best way forward for local people, creating councils far better placed to deliver jobs, growth and services.

Chloe Smith: In one way, at least, I am grateful for the very long answer given by the Secretary of State, because my further question is this: will he tell us why, in this matter, he has ignored the wishes of the public, only 3 per cent. of whom want his wilful, capricious and cavalier proposal for a unitary Norwich?

John Denham: I note that three out of the four political parties represented on Norwich city council favour the unitary proposal, and all the parties represented on Exeter city council support that proposal, so that is an indication of support in key places.

Bob Neill: Referring to the accounting officer's letter to the right hon. Gentleman, the Secretary of State for Culture, Media and Sport, the right hon. Member for Exeter (Mr. Bradshaw), made this observation on his blog, which is named "Ben's Brain Bubbles":
	"The selective leaking of internal correspondence has confirmed the suspicions long held in Exeter (and Norwich) that London-based civil servants have consistently been biased against Exeter and Norwich and have been firmly in the county camp."
	Does the right hon. Gentleman agree that that very serious allegation warrants investigation, and if so, will he undertake it? If he disagrees, will he now say so on the record and invite his fellow Secretary of State-

Mr. Speaker: Order. The question is of course about Norfolk only, and I know that the Secretary of State will factor that into his reply.

John Denham: In which case, Mr. Speaker, I take your guidance and will not refer to my right hon. Friend's blog.  [Interruption.]

Bob Neill: On a point of order, Mr. Speaker.

Mr. Speaker: Order.

John Denham: However, it is a matter of record in a statement issued by my Department that there was no leak of correspondence. It was placed in the public domain and provided to the National Audit Office in a perfectly proper way, and I believe it was also provided to a Member who had raised the topic in correspondence.

Mr. Speaker: Order. I simply point out to the hon. Member for Bromley and Chislehurst (Robert Neill) that he ventilated his views very fully and forcefully, and that points of order come after questions.

Gypsy and Traveller Sites

Julie Morgan: What progress has been made in providing security of tenure for Gypsies and Travellers on local authority sites.

Shahid Malik: I begin by paying to tribute to my hon. Friend for her chairing of the all-party group on Gypsy and Traveller law reform. The Government remain committed to bringing security of tenure to local authority Gypsy and Traveller sites, which is a complex issue involving amendments to primary legislation that we must get right. Statutory instruments will be laid as soon as parliamentary time is available.

Julie Morgan: I am dismayed that Gypsies and Travellers as yet have no security of tenure, bearing in mind that the Connors judgment in the European Court was six years ago and the Government's proposals to change the law using the Mobile Homes Act 1983 were more than two years ago. There has been intensive discussion with Gypsies and Travellers and with support groups, and I wish to express my extreme dismay. What hope can the Government give Gypsies and Travellers who are living in uncertain situations and who had great hopes of this Government?

Shahid Malik: I absolutely understand my hon. Friend's frustration, and I know of her commitment to the matter. I think she will fully understand my commitment to it, too. I recently became the first Minister to visit a Gypsy and Traveller site. We are completely committed to the issue. I know that she wants me to say that I will consider the timing, but it would be disingenuous of me to say that knowing that in practical terms, it would be impossible to lay an instrument before Parliament this side of a general election, so I can only apologise.

Non-Domestic Rates

Desmond Swayne: How much on average was paid by a business in non-domestic rates in (a) 1997-98 and (b) the latest year for which figures are available.

Barbara Follett: We do not hold figures for the average bill paid by an individual business for national non-domestic rates in 1997-98 and in more recent years. However, for 1997-98, the figure derived from dividing the net rate yield from local authorities' rating lists by the number of hereditaments on the local list as at 31 December of the previous year is £6,796, and for 2008-09 the equivalent figure is £11,274. That reflects changes in the retail prices index and the NNDR tax base due to increased economic prosperity.

Desmond Swayne: I thank the Minister for that well researched reply. Fully a third of businesses that are eligible for small business rate relief are not claiming it, according to the Government's own figures. What will she do either to simplify the system or to make it automatic?

Barbara Follett: I am afraid the hon. Gentleman's figures are out of date. Recent figures suggest that 92 per cent. of the relief is being claimed.

David Heath: May I ask the Minister to look yet again at how empty property tax works at the moment? I have a lot of constituents who have converted agricultural property into workshops, in line with Government policy, and now find it completely impossible to get business tenants despite their best endeavours. They end up with a financial millstone around their neck for following Government policy. Will she look again at the operation of the tax?

Barbara Follett: I understand the hon. Gentleman's concern, but if the rateable value of such property is less than £18,000, it should not attract empty property rate relief-or should I have said that it should not attract tax? I will be happy to unscramble that answer by meeting him privately.

Justine Greening: I think the hon. Member for Somerton and Frome (Mr. Heath) will need that unscrambled. The hon. Lady's boss, the Secretary of State, recently said that in his opinion, companies will be helped by his business rates revaluation, but the Government are killing community shops across London with a business rates revaluation that will raise business rates by more than half a billion pounds over the next few years. That will affect the shops that we all-particularly elderly and low-income families-rely on: the newsagents, the launderettes and the convenience stores. Why does the future of those London jobs, businesses and communities matter so little to the Secretary of State?

Barbara Follett: Once again, the figures are being exaggerated. Sixty per cent. of businesses will not see any rise in their business rates.

Working Neighbourhoods Fund

Joan Walley: What recent estimate he has made of the proportion of the working neighbourhoods fund which has been allocated to local authorities.

John Denham: Since 2008, we have allocated over £1.5 billion of working neighbourhoods fund to help local authorities with high rates of worklessness to support their communities. That has all been allocated to local authorities.

Joan Walley: Of the £1.5 billion allocated, I thank the Secretary of State for the £27 million that has come to Stoke-on-Trent from the working neighbourhood funds. Will he join me in congratulating the jobs, enterprise and training centre in Burslem, the YMCA and the charity Groundwork on the difference they make to helping the long-term unemployed to get back to work?

John Denham: I am delighted to praise the organisations that my hon. Friend mentions. The JET centres use the working neighbourhoods fund and other sources of money, and the organisations she mentions all play a very valuable role. One of the aims of the working neighbourhoods fund has been to allow local authorities to tailor what they do for workless people to the needs of local areas. In many areas, the sort of voluntary organisations she talks about are key to success.

Nigel Evans: I understand that no such funding came to Lancashire last year. Will the Secretary of State ensure that local authorities are able to implement the working neighbourhood fund flexibly, so that they can aid projects to regenerate communities in rural areas such as the one I represent, where we have seen firms, shops and local schools close, or where there are sometimes no rural buses?

John Denham: The working neighbourhoods fund has been targeted at those areas with the highest levels of worklessness and deprivation. That has been the right thing to do, but it is within the area-based grant, which gives local authorities the maximum flexibility locally in tailoring what they do to local needs. Obviously, other Government initiatives-for example, to help high streets suffering from empty shops-have gone to a wider range of local authorities, including some in rural areas.

Shona McIsaac: North East Lincolnshire council was allocated more than £13 million of working neighbourhood funding. However, to date, it has used just £1.5 million of that. Will my right hon. Friend tell me what checks are made on councils to see that they are actually using the money for the purpose for which it is intended? I fear that some of my constituents could have lost out because the council has just sat on that money.

John Denham: That is a very important issue, and I understand that my hon. Friend is meeting my right hon. Friend the Minister for Regional Economic Development and Co-ordination later this week to discuss it. There really is no excuse for local authorities not to spend the money that they have been allocated to help people through the recession and to get into work. There is another crucial issue here. The Government have rightly listened to local authorities that say, "Don't ring-fence every penny and tell us exactly how to spend it. Trust us." When that trust breaks down, and when money is not used, there is a real problem, which I hope can be addressed very quickly.

House Building Targets

Michael Fabricant: What recent representations he has received on his Department's target to build 3 million houses by 2020; and if he will make a statement.

John Healey: The Department receives a large number of representations on house building. I must tell the hon. Gentleman that almost all of them argue that we should do more to build more homes in all parts of the country, including Lichfield. That is exactly what I have set out to do in my great nine months as Housing Minister.

Michael Fabricant: Oh good! Anyway, of the 3 million homes, he will know that the Government project that 1 million will be built as affordable homes by 2020, but the Home Builders Federation has said that the Government will achieve less than half that number. Has it got that wrong?

John Healey: No, the HBF is reflecting the fact that, over the last 12 to 18 months, during the most serious recession in this country for 60 years, private sector house building by the HBF's members has fallen through the floor. At the same time, instead of stepping back, we have increased the investment in building affordable homes and we will build more this year and next year than in any year since we came to government.

Lindsay Hoyle: Will my right hon. Friend look to ensure that authorities such as Chorley, which are sitting on section 106 money that is meant for social and affordable housing, spend that money and provide the homes that are much needed?

John Healey: For the first time, I have made available Government grants and backing, on a similar basis to housing associations, to all local councils that are willing to build and want to meet the needs and aspirations that local people have for new homes. That means that this year we have under way the largest council housing building programme for nearly two decades. I am really disappointed that Chorley council is not playing a full part in that programme and not doing more to meet the need for more homes in the area.

Massage Parlours

Anthony Steen: If he will issue guidance to local authorities on the granting of licences for massage parlours.

Barbara Follett: My Department has no plans to issue guidance to local authorities on the granting of licences to massage parlours, because in most areas they are treated as ordinary businesses and do not require special licences. However, things are changing and some authorities, particularly in London, now require such businesses to have a licence.

Anthony Steen: I suggest to the Minister that all local authorities should require special treatment licences but, although it is all well and good to have licences, what will she do to ensure that officials make regular visits to these massage parlours to identify and help victims of human trafficking who are often found there and need to be rescued?

Barbara Follett: I thank the hon. Gentleman, who has a long and honourable history of concern about this subject. The problem is that most of this issue falls under the Home Office, and another small section of it under the Department for Culture, Media and Sport, so however much I might like to encourage officials in DCLG to pay regular visits to check such establishments, I do not think that I could.

Home Information Packs

James Duddridge: If he will make it his policy to suspend or abolish home information packs.

Ian Austin: The answer is no.

James Duddridge: It is unfortunate that the Minister has not taken a little more time to review the issue. If he had, he might have looked at Northern Ireland where Ministers introduced energy performance certificates without HIPs. Perhaps after he has done so, he might be able to take the opportunity to come back to the House with a fuller answer.

Ian Austin: Despite the difficulties in the housing market, HIPs are helping to speed up the process. A survey of 37,000 transactions- [ Interruption. ] Well, what happens is that every month, those guys-I am sorry, I mean the Opposition-come along and ask these questions and I have to tell them that a survey of 37,000 transactions showed that when a HIP is available, exchanges were completed more quickly. I accept that HIPs were criticised following their introduction in 2007, but we listened to those criticisms and have made major changes to improve the system, introducing the new property information questionnaire containing basic information that buyers said that they wanted; improving the quality of searches; binding in the practice of using insurance; and providing that HIPs must be available when marketing starts.

Regional Regeneration

Joan Humble: What his most recent assessment is of the effectiveness of Government support for local authority regeneration initiatives in the north-west; and if he will make a statement.

Rosie Winterton: Since its inception in 1999 the Northwest Regional Development Agency has consistently met or exceeded all targets set by the Government. In addition, the Government have allocated £480 million to local authorities in the north-west via the working neighbourhoods fund and the local enterprise growth initiative to enable them to tackle worklessness and support enterprise in deprived areas.

Joan Humble: A clear indication of the effectiveness of the Government's plans for regeneration in Blackpool has been the substantial rise-in some instances, 40 per cent.-in the numbers of visitors to the town. Some have come to see the new St. John's square, the Brilliance project and the new promenade taking shape. Will the Minister continue, therefore, to support regeneration projects in Blackpool and the regional development agency's excellent work?

Rosie Winterton: First, may I pay tribute to my hon. Friend for all her work on behalf of her constituents in Blackpool? I was glancing through a document on the economic impact of the Northwest Regional Development Agency and noticed that there is a Blackpool masterplan encompassing many of the issues she just mentioned. She is right to say that we need action from the local authority and regional development agency to bring about the kind of economic regeneration to which she referred.

Nicholas Winterton: Will the Minister accept that county towns such as Macclesfield could do with assistance from regeneration funds, particularly now when we are seeking to establish in Macclesfield a national silk centre? I hope to meet the chief executive of the Northwest Regional Development Agency shortly. Will the Minister give this project her support?

Rosie Winterton: I am sure that the hon. Gentleman will bring the merits of the silk centre to the attention of the chief executive of the Northwest Regional Development Agency. The hon. Gentleman is making exactly the same point I was making earlier: it is vital to have this kind of strategic assessment of the economic needs of all the region, and I hope that he will put his best efforts into persuading his Front-Bench colleagues that they are wrong to want to abolish the regional development agencies in the way that they have set out.

Derek Twigg: One of the most important local authority regeneration initiatives is the proposed Mersey gateway bridge, which will provide hundreds of construction jobs and thousands of jobs thereafter. Will my right hon. Friend speak to her opposite number in the Department for Transport to ensure that we get a decision quickly, because the planning inspection decision comes from within that Department? We need a quick decision to get on with the project, create those jobs and sort out the congestion in my constituency.

Rosie Winterton: I pay tribute to the work that my hon. Friend has done on this matter. When I was a Transport Minister, I met him and colleagues from the council to discuss the project, and I know how valuable it is to the local economy, so I shall certainly bring his point to the attention of Transport Ministers.

Topical Questions

Alun Michael: If he will make a statement on his departmental responsibilities.

John Denham: Much has been achieved on antisocial behaviour, and the number of people who think that it is a problem in their neighbourhood has fallen to the lowest level since records began. However, there are still communities where such behaviour causes problems, and people need to feel confident that they, with the police and local councils, can tackle the problem. Last month, we began training up to 10,000 community champions to join their neighbours, police and councils to take a stand against antisocial behaviour.

Alun Michael: I am delighted to hear that my right hon. Friend is focusing on tackling antisocial behaviour. In view of the importance of local authorities working with the police to drive down crime, will he encourage local authorities across England to follow the experience in Cardiff, where a joint analysis, involving the NHS, of violent incidents has led to a reduction in violent incidents by more than 40 per cent. in terms of the numbers of people coming through the doors of accident and emergency departments requiring treatment?

John Denham: Yes, I will. I understand that lessons from the Cardiff approach are being followed through in Leicestershire and Tyne and Wear. More generally, the Total Place approach, which we are pioneering and which is looking at all public service spending, will encourage the health service, local authorities, the police and others to work together much more closely to tackle such problems in the future.

Alan Beith: Given that school transport comes out of the general local government funding formula, and not the education budget, and that it is being reviewed, will sparsity be looked at carefully given that it has a huge impact now in scattered areas such as Northumberland? Potentially, that impact will be even greater when education is compulsory up to 18.

Barbara Follett: Obviously, local authorities receive funding. Northumberland has just received a 2.9 per cent. increase in funding and has the flexibility to use it as it wishes. However, we will consider the point that the right hon. Gentleman has raised.

John Robertson: Is my right hon. Friend concerned about some local councils charging extra for some lesser services, but in the meantime keeping council tax low for political purposes and not meeting the needs of the poor and the needy?

John Denham: I am concerned about that. Charging for some local services has always been part of the operation of local government, but some local authorities now seem to have a deliberate strategy of keeping basic services as basic as possible and allowing people on middle incomes to get a decent service only if they are prepared to pay twice. That is not the way that I want to see local government services going, and my hon. Friend is quite right to highlight those political parties that are indulging in that approach.

Desmond Swayne: Will the Secretary of State take this opportunity to address the question put to him earlier by my hon. Friend the Member for Meriden (Mrs. Spelman); namely, where will the funding come from in the current financial year to provide for the Government's proposals on social care?

John Denham: As I set out earlier, local government has already planned to make efficiency savings. We believe that it can make the additional savings needed to fund services for the new policy, which comes in not at the beginning of the coming year, but halfway through it. The hon. Gentleman will recognise that, as I said earlier, the policy will be accompanied by the biggest transfer of funding into local government from the national health service since the establishment of the NHS in 1948. I hope that he will welcome that.

Joan Humble: Does the Minister share my concern and that of many other Blackpool residents that our local Conservative council is refusing to put in an extra £148,000 to repair the many potholes that have appeared after the winter, when it has £6.8 million in reserves?

Barbara Follett: I share my hon. Friend's concern about that. The weather has been exceptionally severe. That is why, in acknowledging the problems of the severe weather, the Government have trebled funding to local authorities to invest in their roads, and last year we announced new funding to help them better assess the condition of their roads.

Paul Rowen: I am sure that the Secretary of State is aware that the mortgage repossession scheme operated by Rochdale council has been one of the most successful in the country in keeping people in their own homes. However, funding for that scheme nationally is available only until next year. What steps will the Secretary of State take to ensure that funding is available when the current funding finishes next year?

John Healey: I welcome the hon. Gentleman's recognition that the steps that we have taken locally and nationally, including on the funding to support the scheme, to try to help people struggling with their mortgages during this recession have been working well. We have put that funding in place for this year and next year. That action-Government action that we have been prepared to take-is one of the reasons why repossessions in this recession are running at around half the rate that they were in the last recession.

Andrew MacKinlay: May I take the Secretary of State back to the issue of maximising scarce resources, efficiency savings and protecting front-line services, and offer a view? The problem is that since 1974, Labour, Liberal and Conservative Governments and councils-all three parties have been equally to blame-have constantly reorganised local government, creating unnecessary tiers of management. Why do we not return to a lean machine, get rid of the layers of management in local authorities and start calling people "The borough engineer" or "The surveyor", which people understand, rather than calling them after these God-almighty directorships of something-or-other, which vary from week to week?

John Denham: May I reassure my hon. Friend that although the report from the taskforce on making efficiencies in local government-

Andrew MacKinlay: His name's Bullock, isn't it?

John Denham: Bullock and Leese. The taskforce does not, as I recall, call for the re-establishment of the position of borough surveyor; none the less, it directly addresses the need to reduce layers of management both within local authorities and, in particular, between them in areas with two-tier councils.

Anthony Steen: From next month lap dancing will have to be licensed by local authorities. Will the Secretary of State look into whether the income from the lap dancing licence should go into paying officials to spot whether the conditions are being met and whether any of the girls dancing in a club may have been trafficked?

Barbara Follett: I am sorry to give the hon. Gentleman a disappointing answer, but his question does not really fall under the remit of my Department. He will have to address it to the Department for Culture, Media and Sport or to the Home Office.

Lindsay Hoyle: Do those on the Front Bench agree that local authorities that are paying compensation for bullying ought to offer better training and that they should be better employers? Should not the public also have a right to know how much money is being paid out in such circumstances?

John Denham: I am on record as being very much in favour of people having as much knowledge as possible about local authorities' spending. We have set out measures over the past few months to ensure that that happens. We also believe that people working in local government, which is a vital public service, deserve the best quality of human resources management, as it is called in the jargon these days. What that really means is treating people properly and with respect.

Greg Mulholland: Thousands of students in Leeds and around the country are still not protected by the tenancy shorthold protection scheme. Last November, the Under-Secretary of State for Communities and Local Government, the hon. Member for Dudley, North (Mr. Austin) said that the Government would shortly be publishing the results of the review, but those people are still not being protected. Will he give us an update and tell us why that is the case?

Ian Austin: I cannot give the hon. Gentleman that information now, but I would be happy to meet him and discuss the matter in detail.

Peter Bone: A few days ago, the Secretary of State gave permission for 3,000 new homes to be built in Wellingborough north, against the wishes of local residents, local councillors and myself. What democratic credibility can this Government have when the Secretary of State makes such a decision so near to a general election?

John Denham: Since I came into the House in 1992, I have held the view that Parliament and this House were sovereign. I do not share the concept that there is a period of time when the House is sitting when decisions should not be taken. Decisions are taken properly and in accordance with the law, after we have considered all the relevant processes. It is only right that Ministers should continue to take decisions as long as the House is sitting as a properly constituted, democratically elected Chamber.

Peter Luff: Given the consensus that exists in areas such as south Worcestershire about the need for more homes-and for more affordable homes, in particular-may I urge the Secretary of State, even at this late stage, to tear up the west midlands regional spatial strategy and to allow local communities to decide exactly how many houses they need and precisely where they should go?

John Denham: It is important that the combination of local, regional and national policy should be used to secure sufficient homes to meet the needs of families in this country in the future. We have rejected calls to scrap regional spatial strategies and planning targets and to leave everything to decision making at local level because we know full well that the house building industry would grind to a halt, that land would not be available, that growth would be slowed and that the needs of this country's families would not be met. The house building industry is terrified by the prospect of such a policy being brought into play.

Several hon. Members: rose -

Mr. Speaker: Order. I would like to accommodate several more colleagues, but I hope that they will be considerate of each other.

Martin Horwood: After five years, the south-west regional spatial strategy is still grinding on with unsustainable housing targets that are way in excess of economic reality and local housing need. It has attracted 37,000 objections and run into legal challenges; it has also now clearly run out of time. When will the Government admit defeat and return to local people their right to plan the houses that they need where people want them?

John Denham: The total number of houses is based not on some whim of central Government but on a hard-headed assessment of need. That need translates into the families of this country who want to know that their children will have homes that they can move into, and that there will be provision for elderly people in the future. Those who pretend that we can simply say that we are not going to provide that housing and that someone else will provide the space in which our children need to live are wrong. It is enormously damaging to suggest that. It is also, frankly, misleading to local people to suggest that the hon. Gentleman's approach would work. There must be a mature discussion in this country about meeting the needs of people now and in the future, and I am sorry that he does not share that view.

Robert Key: The South West of England Regional Development Agency is pumping millions into the Porton science park in my constituency, in partnership with Wiltshire council, which is regenerating the social and physical infrastructure. Will the Secretary of State have a word with Ministers in the Department of Health, who are talking about supporting the Health Protection Agency in moving nearly 800 of its work force out of the south-west, which needs the jobs, into the overcrowded south-east? Is the Lyons review still living, or is it dead?

John Denham: I will talk to my right hon. Friend at the Department of Health if the hon. Gentleman will talk to his hon. Friend on the Front Bench to say how crazy it would be to scrap the regional development agency that he values so highly in his constituency, because that is exactly what would happen.

Michael Fallon: Why is the junior Minister for local government refusing to meet me to discuss the persistently low level of grant given to Sevenoaks district council? It has had an increase of only 7 per cent. over the last 10 years compared to an average for district councils of more than 50 per cent. Will she reconsider?

Barbara Follett: I apologise to the hon. Gentleman; I was not aware that I was persistently refusing, and I would be most happy to see him.

Simon Hughes: My local council wants to build and renovate many more affordable homes. Will the Government give Southwark council permission to borrow at the lowest interest rates that the market offers rather than at the highest rates that it is currently locked into?

John Healey: We are not just making grant available to support councils that want to build affordable homes across the country, including in Southwark, but we are looking at ways of dismantling the system of financing council housing for the future. I hope to be able to update the House on that before long.

Patrick Cormack: How does the Secretary of State reconcile his duty to champion local government with his decision to impose unitary authorities that are not wanted? Does he believe that the gentleman in Whitehall still knows best?

John Denham: The proposals we are putting forward are indeed wanted in Exeter and in Norwich. My right hon. Friend the Minister for Regional Economic Development and Co-ordination and I propose having a unitary council for Exeter and one for Norwich, which I think is the right thing to do.

Bob Spink: Further to the question put by the hon. Member for Thurrock (Andrew Mackinlay), does the Secretary of State believe that the pay packages of senior council officers have increased for selfish reasons to indefensible levels? Does he believe, as I do, that it is time that we slimmed down these fat cats?

John Denham: It is very clear that over a period of time in which the average pay of council workers has gone up by £6,000 a year, the average pay of chief executives has gone up by £40,000 a year. Although I pay tribute to the vast majority of those people with a lifetime of public service, things have got out of hand at the top. That is why we have required from April the publication of the full details of every named post in which an individual is paid more than £150,000 a year, and details of the pay in £5,000 bands from £50,000 upwards. I will also talk to local government about what further measures we can take when it is proposed to create or fill one of these very highly paid posts.

Greg Hands: Turning to the earlier question about Hammersmith and Fulham, the Secretary of State seemed entirely unaware of the quote that he had made about the leader of the council, so let me take him back to the opening line of his party conference speech, when he said:
	"'They are hard to get rid of', the Tory Leader of Hammersmith and Fulham moans about his council tenants."
	That was an invented quote, which has been repeated many times by his colleagues, including in the document, "Cameron's Councils". Will he finally take the opportunity to withdraw this disgraceful slur on one of the best-run councils in the country?

John Denham: I am grateful to the hon. Gentleman for drawing attention to the publication Cameron's Councils", because it sets out for everybody the very clear warning of what it would be like if people were so ill advised as to elect a Conservative Government.

Point of Order

Andrew Selous: I rise to make a point of order, of which I gave your office notice yesterday, in connection with the shameful behaviour of the Department for Work and Pensions in failing to answer written parliamentary questions tabled by me and other Front-Bench colleagues-specifically, questions 316961 and 316962. What action are you able to take, Mr. Speaker, to ensure that Government Ministers are indeed accountable to all Members? These questions were asked more than a calendar month ago, and I suspect that the Department wishes to bury bad news by not answering them. How can you help me, Sir?

Mr. Speaker: I thank the hon. Gentleman both for his point of order and for giving me notice of it. Let me reiterate the position that is expected of Ministers in all Departments: timely replies should be provided to written parliamentary questions.
	I was waiting for what I regarded as the crux of the hon. Gentleman's inquiry, namely the length of time for which he had been waiting. For him to table a question and find a month later that he had not received any reply-or, at any rate, had received no substantive reply-was not satisfactory.
	The hon. Gentleman will be aware of the new system that I have introduced, which gives better transparency to the record of Departments in answering questions. I had hoped that that would serve to shame Departments into superior performance. If it has not, we may have to look at the thing again, but it really will not do.

Hydrofluorocarbons Limitation

Motion for leave to bring in a Bill (Standing Order No. 23)

Clive Efford: I beg to move,
	That leave be given to bring in a Bill to make provision for limiting the use of hydrofluorocarbons in certain premises; and for connected purposes.
	The purpose of the Bill is to bring an end to the use of hydrofluorocarbons, or HFCs, in the refrigeration units of large supermarkets-

Mr. Speaker: Order. I apologise for interrupting the hon. Gentleman, and I hope that the clock can be stopped, but I should be grateful if Members who are leaving the Chamber would do so quickly and quietly. The noise is very discourteous to the Member who has the Floor. I hope that we can have some regard to the way in which our proceedings are viewed by people outside this place.

Clive Efford: Thank you, Mr. Speaker.
	Last year, I presented a similar Bill in an attempt to persuade the Government to regulate for the complete phasing out of HFCs in large supermarkets. Today, I shall attempt to impress on them three facts which I hope will convince them that it is time to act. HFCs are extremely harmful in terms of global warming and represent a growing proportion of our emissions. There is little to suggest that current European Union and United Kingdom regulation in the field has encouraged large retailers to speed up the process of eradicating the use of HFCs in their stores, and there is nothing in EU regulation to prevent the Government from regulating in this regard.
	According to Greenpeace, HFCs can be up to 20,000 times more damaging in terms of global warming than carbon dioxide. The most common gas used in supermarket refrigeration, HFC-404A, is 3,800 times more harmful than carbon dioxide. It is predicted that by 2020 HFC emissions will be equivalent to between 2 billion and 2.6 billion tonnes of carbon dioxide, approximately four times the level of the United Kingdom's annual greenhouse gas emissions. In 2005, stationary refrigeration units were the biggest source of F-gas emissions in the UK, and within that total, supermarkets account for more than half the emissions. Phasing out the HFCs in supermarkets has the potential to save more than 175 million tonnes of carbon dioxide equivalence between now and 2050. That is equivalent to a quarter of the UK's annual carbon dioxide emissions.
	The potential impact of gases on global warming is averaged over 100 years, which reflects the extraordinarily long time that gases responsible for global warming remain in the atmosphere and add to the problem. HFCs do not last for 100 years. The evidence is that global warming is accelerating. Prompt action now to remove gases that are 4,000 times more harmful than carbon dioxide and do not linger as long as other harmful gases has the attraction of buying much-needed time for other greenhouse gas mitigating measures to take effect. I hope the Minister will accept that the time to act is now.
	I presented my Bill last year in response to a report from the Environmental Investigation Agency on the use of hydrofluorocarbons in supermarket refrigeration units. I commend the agency on its work. Its report was prompted by the announcement by a group of large supermarkets that they intend to move away from the use of HFCs. The EIA carried out its survey to monitor progress in August 2008. Its conclusions were not encouraging-the best-performing supermarket succeeded in reducing its HFC use in only three out of 620 stores.
	The figures for other supermarkets were just four out of 1,700 stores and one out of 2,250 stores. I shall not name and shame the supermarkets involved, because the response in this area has been so mixed. The stated view from many in the industry is that regulation in this area would create the confidence across the industry to plan ahead, knowing that the supermarkets are all operating within the same framework. Such an approach would bring about the stated objective of the Department, which is to eradicate the use of HFCs. That view still applies today.
	Following the presentation of my Bill last year, my hon. Friend the Minister of State, Department for Environment, Food and Rural Affairs wrote a letter to the EIA on 11 November in which he accepted that supermarkets were the "big emitters" and that
	"reducing their emissions is a key focus of Defra's work to reduce HFC emissions overall."
	He went on to say that in the short term the Government anticipate that
	"with the comprehensive EU and GB regulatory framework now fully in force, significant reductions"-
	in the use of HFCs-
	"will be achieved in the next few years."
	I am sorry to say that there is little evidence that that is moving companies in the right direction.
	In Aug 2009, the EIA carried out a further study of large supermarkets to see how far they had got in moving away from being dependent on these extremely harmful gases. Only 2 per cent. of the major stores in the UK are running HFC-free refrigeration systems-only 46 are now HFC-free compared with 14 last year. One of the largest supermarkets has experimented with HFCs but has reneged on its promise to switch all its stores away from the use of HFCs, while one major chain continues to use HCFCs-hydrochlorofluorocarbons-which are supposed to be phased out this year. Aldi, Morrisons and Sainsbury's refused to share their data on leakages, and so I shall make an exception in naming them. The level of the leakages emitted into the atmosphere reported to the EIA ranged from 14 to 17 per cent. of HFCs, so I am afraid that my hon. Friend's confidence that the current regulatory regimes in the EU and the UK are sufficient to meet the urgent need for action on HFCs is misplaced. I hope that he will accept the argument that the time to regulate has come.
	My third point is that nothing in the competition rules prevents the Government from regulating in this area. May I refer the Minister to article 95 of the treaty establishing the Economic Community which, following the passage of the treaty of Lisbon-I pardon him if he starts to fall asleep as I read this technical section-became article 114 of the treaty on the functioning of the European Community, TFEC? While on the approximation of laws, I should mention that paragraphs 4, 5, 6 and 7 of the article are the most relevant. They clearly demonstrate the need for the Government to make a case for the eradication of HFCs here in the UK-nothing is preventing the Government from making that case.
	The Commission would then be required to consider whether this form of practice was aimed at seeking advantage over other EU countries or companies that operate within those countries and whether the UK was seeking to exclude those people from free trade with the UK. Those paragraphs contain clear powers for the UK to regulate to tackle environmental issues. Nothing excludes the UK from acting in this area and preventing the further use of HFCs in the future.
	So, in conclusion, may I urge my hon. Friends in the Department to take on board the three arguments that I have made today and to agree to meet me and the EIA in the near future to discuss ways in which we can make a case to the European Commission that we are not breaching European competition laws, that there is scientific evidence that proves that it is necessary for us to act in this field, that current European and UK regulations are not moving the large supermarket chains along the road of eradicating hydrofluorocarbons and that action in the UK is absolutely necessary? With that, I commend the Bill to the House.

Lembit �pik: I rise to comment on this Bill, provoked by the question of why we need such legislation in the first place. I agree with the intentions and objectives of the hon. Member for Eltham (Clive Efford), but I am extremely worried about the situation in which we find ourselves. We always talk about the environment, as do the supermarkets, yet they do not feel compelled to act without the threat of legislation. Like the hon. Gentleman, I have heard the supermarkets making various claims on this matter, as well as various general commitments to phasing out the hydrofluorocarbon-related refrigeration units that he has described. However, as he has rightly pointed out, the reality is far from the public relations commitments. If the supermarkets are serious about the environment and about improving their environmental footprint, as they incessantly tell us in their advertising, they ought to be making a formal statement about what date they will set for themselves to phase out the refrigeration units in question-perhaps 31 December 2015, which would give them half a decade to finish the job.
	It seems to me that it would be unhelpful for me to divide the House on this matter-it would be a poor use of the Chamber's time-but I want to put on the record my view that if no action is unilaterally taken by the supermarkets without this legislation, we cannot accept their claims that they take the environment seriously. I fear that not only will the supermarkets give us more words without action, but when it comes down to a fairly straightforward change of the type that the hon. Gentleman wants to see, they will be resistant for purely economic reasons. The environment is more important than that.
	Let us see whether this ten-minute Bill causes the supermarkets to act and to make a commitment to act in the next few days. If they do not, not only will I be disappointed by the claimed intentions of supermarkets not being followed up with action, but I will also feel that the prognosis for the environment as a whole is grim indeed.
	 Question put (Standing Order No. 23) and agreed to.
	 Ordered,
	That Clive Efford, Steve Webb, Norman Baker, Peter Bottomley, Andrew George, Mr. David Drew, Jim Dowd, Mr. Michael Meacher, Mr. Andrew Dismore, Ms Karen Buck, John Austin and Mrs. Ann Cryer present the Bill.
	Clive Efford accordingly presented the Bill.
	 Bill read the First time; to be read a Second time on Friday 30 April and to be printed (Bill 81).

Opposition Day
	  
	[5th Allotted Day]

Health Care in London

Mr. Speaker: I inform the House that I have selected the amendment in the name of the Prime Minister. The House will also be conscious that I have imposed a limit of eight minutes on Back-Bench contributions both in this debate and in the second Opposition day debate.

Andrew Lansley: I beg to move,
	That this House recognises that London has some of the leading hospitals and healthcare services and expertise in the world; notes with concern that some areas of London have the worst outcomes for stroke, heart disease and cancer in the country; is alarmed that health inequalities in the capital rank among the worst in the country; believes in improving services to meet the needs of London's 7.5 million inhabitants; calls for the delivery of a public health strategy geared towards the reduction of health inequalities; calls on NHS London to halt the implementation of current sector-wide reconfiguration proposals across London, including accident and emergency services, until a more effective public consultation is in place; further calls for service configurations that are soundly evidence-based and which meet the choice of patients and the referral intentions of local GPs; further believes that consultant-led obstetric departments and maternity units should not be closed, whilst they are safe, accessible and responsive to a continuing need; and calls on NHS London and the Department of Health to publish the details of the commitments made at the time of the Olympics bid to fund healthcare services in the capital, and to disclose what the current estimate is of the cost of providing services for the Olympics and how it is proposed that this should be funded.
	Members of the House, particularly the many with London constituencies, will be aware that for the past two years there has been a process called Healthcare for London, which has increasingly sought to prescribe to the health economies across London how they should design their services, which services should be provided and by whom, and, by implication therefore, where patients should go for their treatment. The purpose of the debate is to give the House, for what I think is the first time, the opportunity to express a view on how we want health care services in London to be provided in future. We want literally to fire a shot across the bows of those in the upper hierarchies of the NHS who want to determine these things without reference to the public whom they serve, to the general practitioners who refer patients, or to the patients themselves, who have a right to exercise choice. We also want to give the House an opportunity to set out how it wishes Healthcare for London to be improved in the years ahead.
	My first point is at the heart of improving health outcomes. We need to focus on improving public health in London, which has some of the greatest health inequalities in the country. At ward level, between Tottenham and Kensington and Chelsea, for example, there is a disparity in life expectancy of 17 years. I know that such disparities exist in other parts of the country, but those are very pronounced. We feel the issue even more keenly when we see such relative wealth and poverty side by side in London, where nearly one in four children live in poverty.
	There are many specific health problems that are greater in London than anywhere else in the country. The level of sexually transmitted infections is higher in London than anywhere else, and the level of alcohol abuse and dependency is higher than in any other region in the country, as is the level of drug use and abuse. We know-not least because London is where many refugees, asylum seekers and, indeed, rough sleepers are found-that London has 40 per cent. of the total number of tuberculosis cases in the country and more than 50 per cent. of HIV cases. The importance of having an effective public health strategy must be at the heart of this issue.
	I commend the Mayor of London for the health inequalities strategy that he published last October. I shall not dwell on that at length, although there is plenty of reason to do so, because time will not permit it. The document that I published with my right hon. Friend the Member for Witney (Mr. Cameron) in February was about focusing on public health, having a dedicated public health budget and having a health premium that is intended to support successful local strategies.
	In the London context, I want to make it clear that if we were given the opportunity to do so by the electorate of London, we would equip the local NHS with individual London boroughs to pursue locally owned strategies to improve public health. We also intend that the NHS should co-operate, on a London basis, directly with the Mayor of London to pursue the health inequalities strategy. Given the particular characteristic of London as a city with city-wide government, we want that city-wide government to bear down on the particular public health challenges that I have mentioned and to exploit opportunities for promoting better health in London, and I know from my conversations with the Mayor that he is immensely keen to do that.

Mike O'Brien: I share the hon. Gentleman's concern about health inequalities in London, and I am curious to know how much money he would transfer from Chelsea to Haringey, for example, to deal with those relative inequalities.

Andrew Lansley: As the Minister is in no position to tell us what the spending in individual primary care trusts will be beyond 2010-11, I shall not take any lectures from him on this. What we are clear about-this has never happened under a Labour Government-is having a direct focus on public health outcomes and a determination to use the resources of the NHS to reward successful strategies. It is understood as well in Kensington and Chelsea as it is in Haringey or Tottenham that the places with the worst current health outcomes should be where we focus our public health resources not only to improve everybody's health but to narrow those health inequalities.

Tom Brake: Will the hon. Gentleman give way?

Andrew Lansley: In a second, as I want to make the point set out in our motion. We have previously given Ministers a chance to be clear about what implications and opportunities will arise for the NHS and London through the Olympics. Clearly, the games represent a very great opportunity in public health terms, and we have to make sure that the legacy will be realised. However, some very particular costs will arise in 2012 itself, and I think, from what he said two or three weeks ago, that the Minister has estimated them to be in the order of some £30 million.
	When he replies, I hope that the Minister will tell us precisely what the costs are. What commitments on costs have been given to the London Organising Committee of the Olympic Games, and how does he intend them to be met in the NHS in London during 2012?

Tom Brake: I thank the hon. Gentleman for giving way. On the subject of implications, will he make it clear to the House whether there are any implications for the Better Healthcare Closer to Home programme, which affects residents in Sutton and Merton? The programme would provide a new hospital on the St. Helier site, and local care hospitals in the area. Will he confirm that the argument that he is deploying today about what should happen with the NHS in London will have no implications for that programme?

Andrew Lansley: I assure the hon. Gentleman that what I have said about public health will not impact directly on the availability of NHS services. I remind the House about the current level of spending on public health care in London through the Healthy Living programme.  [ Interruption. ] The Minister might be interested in this, because 13 primary care trusts in London spend more on management than they do on public health under the Healthy Living programme.
	Across London, the average spend on the Healthy Living programme is £38 a head, and average management costs are more than £30 a head. The total for management costs in London is £246 million a year, and that shows a rise of 22 per cent. in just the past three years. We want to cut those management costs by a third over the next four years. We will reinvest all the money, because we aim to protect the NHS budget and increase it in real terms every year. That means that we will be able to ensure that we have less bureaucracy and more promotion of public health.

David Burrowes: No areas of public health are more important than drug abuse and drug treatment. A great deal of public money has gone into them, targets have been set and a huge amount of management brought to bear, yet very little has been achieved in terms of outcomes or recovery from addictions. Is not that a prime example of Labour failure?

Andrew Lansley: Yes; my hon. Friend has made a very important point. We have to be focused on results. I am afraid that for too long parts of the country have said, We have relatively poor outcomes, so we must have more money, yet the money has never been used to deliver proper results.
	I make no pretence about the fact that it is a tough call. In straitened financial circumstances, we intend that the dedicated public health budget will rise in real terms, but we have to ensure that that will deliver results. As we made clear in our public health green paper, we believe that we stand a much better chance of achieving those results if we engage properly with local authorities and the NHS as a local strategy, with voluntary-sector bodies as deliverers. That approach will help charities and voluntary-sector organisations, when the results come through from the services that they provide, to believe that their funding will be locked in on a more permanent basis. That will be better than the constant flow of short-term initiatives that have so undermined them in the past.

Edward Davey: Will the hon. Gentleman give way?

Andrew Lansley: No, as I want to make some points about the Healthcare for London programme.
	In January, NHS London published an overall strategic plan, and we have begun to see some of the so-called sector plans for different areas of London. The plan for outer north-east London has been published and the one for north-west London has been leaked. In addition, people are speculating about what the implications might be for other places across London.
	There are questions about the assumptions underlying the NHS London approach. It does not help that the text of the document published in January by NHS London is confusing and erroneous. The notes relating to the scenarios and the funding figures were transposed, they did not include the base case at all, and they were wrong. For example, there was a reference to 2.3 per cent. per annum funding growth in the next spending review period, which should have been minus 2.3 per cent. Essentially, NHS London is assuming that there will be unchanged real terms funding for the NHS all the way through to 2016-17. Alongside that, it assumes 3.5 per cent. cost inflation in the NHS. We need to challenge the assumption that costs can be accommodated in that way. NHS London also assumes 4 per cent. a year demand growth, which is not in line with the projections of demand growth produced by the King's Fund and the Institute for Fiscal Studies on a national basis.
	We know what NHS London set out to do-make a set of assumptions, arrive at a big funding shortfall in 2017, and tell everyone that they must do the things that NHS London is calling for them to do-but let us leave that on one side.
	Under any reasonable set of assumptions, we have to deliver efficiency savings and improving productivity in the NHS, including in London, in ways that have not been adopted in the past. Over the past 10 years, when funding for the NHS has more than doubled, how is it possible that in London there is still legacy debt of more than £500 million for the NHS trusts and a worrying number of financially challenged trusts, and very few of the changes that should have taken place in the NHS to redesign services and deliver care more appropriately and more effectively have happened? Perhaps the Minister will explain.
	The moment when the financial pressures are assumed to begin is the moment when NHS London feels that it must start taking the management action necessary to respond to it. There has been a dereliction of duty. After a 20 per cent. increase in management costs and a £25 million management consultancy cost the year before last, many of the things that needed to be done have not been done.

Bob Neill: My hon. Friend makes a powerful point. Is he aware that that concern is particularly reinforced in south-east London, where it seems that underlying assumptions based on a crisis-driven need to amalgamate three trusts into a huge super-trust are distorting the assumptions and the long-term planning, reinforced by the suggestion in documents seen by the South London Healthcare Trust, that the principal driver of this is to right-size-in other words, financially rectify-the enormous historic deficit that it inherited?

Andrew Lansley: My hon. Friend makes an important point. Experience suggests that merging three failing organisations does not make one big successful organisation. I hope I am proved wrong and that the South London Healthcare Trust succeeds in its objectives, but I am afraid that past evidence does not necessarily support that, and the trust has a massive debt.
	The central issue is that NHS London is making extreme assumptions about the ability to transfer activity from within hospitals to a community context. Alongside that, it is assuming dramatic reductions in cost, which are not proven.

David Evennett: My hon. Friend is making a powerful case. He has visited our area, south-east London, regularly to see at first hand the problems of health care that we had. The regrettable reorganisation that my hon. Friend the Member for Bromley and Chislehurst (Robert Neill) referred to is causing great concern locally about the provision and quality of health care that constituents will receive. There is failure in our area. What reassurance can my hon. Friend the Member for South Cambridgeshire (Mr. Lansley) give our area about the future?

Andrew Lansley: I hope that I can give the reassurance that decisions will be made locally in relation to local needs, local patients' choice and GP referral decisions. My visit with my hon. Friend to his constituency, and the example of Queen Mary's hospital in Sidcup, begin to give the lie to the Government's amendment-in that none of the changes will happen unless and until new services have been developed. That is far from the case at the moment, and it is assumed that patients who are denied access to hospital services will simply be accommodated elsewhere in the community at a lower cost. The assumptions are literally heroic, stating that it will be possible for 55 per cent. of out-patient and 60 per cent. of accident and emergency attendances to take place in the community rather than in the hospital.
	The Government cite the National Primary Care Research and Development Centre, which just over two years ago undertook a study on care closer to home, but that does not for a minute justify the 55 per cent. out-patients figure. All the examples are small-scale, and none systematically demonstrates a reduction in cost if one maintains quality, not least because good-quality community services often have to be delivered by the same hospital specialists-or certainly with them, and as a result of their training and co-operation. The Government cannot point to any evidence that supports their assumptions.

Theresa Villiers: My constituents are hugely concerned about the future of Barnet hospital and Chase Farm hospital. Does my hon. Friend share their anger that the whole NHS London process has been so secretive, compounding fears that it is all about suiting the agenda of NHS managers, not patients?

Andrew Lansley: I entirely agree. My hon. Friend knows about this, because she, other hon. Friends and I have been to see the management of Barnet and Chase Farm Hospitals NHS Trust over five years to try to work out what they propose to do with Chase Farm hospital, and to argue the case for it. Time and again, in the private conversations that we have had, it was clear that options were not being presented. It was also perfectly clear that the management sought to prejudice the public consultation by tying up in advance the views of all the clinicians whom they employed. That is not satisfactory, either.

Richard Ottaway: Does my hon. Friend agree that there is no better example of things not being done that ought to be done than the redevelopment of Purley War Memorial hospital, which is part of the Mayday Healthcare NHS Trust? In 2001 a pledge was given at the Government Dispatch Box to redevelop that hospital. Nine years later, nothing has happened and there are still no concrete plans for redevelopment. Can my hon. Friend assure me that a future Conservative Government will get behind the local authorities and deliver something for the people of south Croydon?

Andrew Lansley: I am glad that my hon. Friend has made that point, because I can give him that assurance. Indeed, I have made it very clear to the chief executive of the Mayday Healthcare NHS Trust that I shall support its action in seeking to develop Purley War Memorial hospital, and I am very pleased that Croydon council is getting behind the project, too, because the planning authority and the NHS trust must be willing to make it happen. That redevelopment is very important, because if the trust is to become a foundation trust that service needs to be provided and that project needs to go ahead.

Edward Davey: I, too, deplore the secrecy of the process. Will the hon. Gentleman therefore join me, and his hon. Friends, in calling for the publication of many documents, including the McKinsey report that lies behind the process, and in my own area, the south-west London strategic plan, which contains many of the options that so concern people?

Andrew Lansley: I entirely agree that it would be very helpful if those management consultancy reports were published. However, our every step has been taken not on the basis of speculating or scaremongering, but entirely on the basis of trying to identify clear evidence. I must confess that I was therefore rather disturbed to find that, according to the associate editor of the  Daily Mirror, Liberal Democrat activists openly boasted that they had stirred up the campaign about the closure of Kingston hospital. No document had been published and there was no documentary evidence to support the closure claim, and the chairman and chief executive of the Kingston Hospital NHS Trust have completely refuted it. My hon. Friend the Member for Hemel Hempstead (Mike Penning) has been to Kingston hospital to discuss this, and he can vouch for that fact.

Greg Hands: rose-

Andrew Lansley: I promised you, Mr. Speaker, that I would confine myself to taking interventions from those who are currently seeking to intervene, and no more than that.

Greg Hands: My hon. Friend will know that the north-west London commissioning partnership is looking at closing five of the eight A and E departments in that sector. At the same time NHS London, in its letter of 22 January 2010, suggested that there should be only one site in the huge Imperial College Healthcare NHS Trust area. What does he think might be the implications of that for the residents of Hammersmith and Fulham, and the royal borough of Kensington and Chelsea?

Andrew Lansley: I am grateful to my hon. Friend, who makes a very important point. One of the assumptions is a 60 per cent. transfer of accident and emergency cases out of A and E and into the community. A study on primary care and emergency departments commissioned, and published last Friday, by the Department of Health, said that, of arrivals at A and E,
	We found that the proportion that could be classified as primary care cases was between 10 per cent. and 30 per cent.
	It went on to say:
	There is good evidence that the majority of patients choose the correct level of care. A few do not and it is always a risk to plan for the few rather than the many.
	In north-west London-we have seen the documentation on that area-it is astonishing to make this proposal and talk about such a massive transfer out of A and E, given last year's figures. In Chelsea and Westminster the rate of A and E attendances has gone up by 4 per cent.; in Ealing the figure is up by 1 per cent.; for Imperial, taking Charing Cross and Hammersmith together, it is up by 9 per cent.; in North West London Hospitals it is up by 15 per cent.; in Hillingdon it is up by 6 per cent.; and in West Middlesex it is up by 5 per cent. All those hospital emergency departments have people pouring in. It is simply not true to say that there is any evidence to support the proposition that the services in the community that would justify what is being proposed in terms of the closure of emergency departments have been put in place.

Iain Duncan Smith: Will my hon. Friend give way?

Several hon. Members: rose -

Andrew Lansley: I will give way to my right hon. Friend the Member for Chingford and Woodford Green (Mr. Duncan Smith), and then take interventions from those who are standing, but I will stop there.

Iain Duncan Smith: Will my hon. Friend bear in mind the fact that we have had exactly this problem in north-east London, where there is a shortfall in spending between the north-west and the north-east? The drive to close Whipps Cross is mainly down to the zealotry of officials, now released from secrecy, and people not telling the truth about it. They talk about pushing stuff out into the community, but in our area there has been a 10 per cent. fall in the number of health visitors, and the caseloads in relation to children under five are at least double that recommended by Lord Laming. It is an utter disaster, but we cannot get those people to face up to that.

Andrew Lansley: My right hon. Friend makes an extremely important point. Putting a walk-in centre or an urgent care centre on the front of a hospital is a perfectly reasonable and sensible idea, but when that happened at Whipps Cross the net effect was 2,000 fewer patients a month attending the emergency department at Whipps Cross, but 4,000 extra patients a month attending the urgent care centre. We should not assume that that leads to lower costs, as it might stimulate demand.

Joan Ryan: The hon. Gentleman referred to Barnet hospital and Chase Farm hospital, which we have discussed before. He knows that I do not support any downgrading of my local A and E, but we have won an important step forward in relation to a 24-hour doctor-led service for the future. These changes will not take place until 2013. He must also know that in an interview with  The London Daily News the Conservatives have said that their position is
	not a guarantee that we will keep AE.
	In Enfield News, which is hand-delivered by the Conservatives, they have said:
	It is impossible to make commitments.
	Does not that say it all about the Tories on the NHS-no commitment?

Andrew Lansley: Time and again I have told the right hon. Lady that we have been committed, over years, to defending the right of local people and local commissioners-general practitioners-in Enfield to determine what services should be provided for them at Chase Farm. It is a disgrace that local people have been ignored in what is being pushed through there. She should talk to the hon. Member for Pendle (Mr. Prentice) to see how good he thinks it is to get rid of an emergency department and put in an urgent care centre, because the local people in Burnley did not accept it. Of course I shall not have a top-down Conservative approach replacing a top-down Labour approach. What we will have is a structure that listens to patients and responds to local GPs, allowing them to be sure that they can put services in place.

Stephen Hammond: My hon. Friend made a comment about Kingston hospital. I was so concerned about some of the campaigning that has gone on, including a challenge in newspapers to me as Conservative MP for Wimbledon, that I met Healthcare for South West London last Friday, and was told that nothing was going to happen. The hon. Member for Kingston and Surbiton (Mr. Davey) has suggested that there should be transparency. Perhaps he and his colleagues would like to publish the evidence that they have on these matters.

Andrew Lansley: I can tell my hon. Friend that after the election, one of two things will happen. There will be either a Labour-derived, top-down plan that threatens to turn many of London's major hospitals into what Labour terms local hospitals, which in some cases seems to mean a move from an emergency department to a GP-led urgent care service-a potentially serious retrograde step when attendance at A and E is rising-or a Conservative approach of trying to allow GPs, local authorities and local people to design services that respond to patient need and choice and provide referral opportunities. If patients are arriving at an A and E department, they should be handled appropriately there.

Stephen Pound: May I say that the hon. Gentleman's remarks at the beginning about health inequality in London were very well made and struck the mood of the House? I profoundly hope that we can discuss this matter without descending into party political rancour. On his point about A and E admissions, Ealing hospital-I was there at the opening, not all that long ago-was built to treat 25,000 people a year but deals with 100,000 a year. Does he agree that although we may well move to a polyclinic model in future, we cannot do that now, and we cannot abandon people in A and E? This is not a matter of Labour and Conservative, but a matter of life and death.

Andrew Lansley: I agree with the hon. Gentleman. That is precisely my point. He is right that Ealing hospital has 100,000 people coming through its doors to its emergency department each year. If it were not there, where would they all go? There is always a case for change, and nothing will be absolutely static, but let us work with the hospitals that we have, and let them start the business of designing new services.
	I see the former Secretary of State, the right hon. Member for Holborn and St. Pancras (Frank Dobson), in his place. He was out with his colleagues and others protesting about the possible closure of the emergency department at the Whittington, which is on the same scale. We should work with hospitals in London and say that, yes, we may need to design better services, a care pathway that extends out into the community and services that are more integrated around patients instead of having a primary-secondary divide, but we should give the hospitals the opportunity to deliver those services. We have a lot of hospital sites in London, many of which are accessible to much of the population, and we can deliver services from them rather than shut them down and open polyclinics, as with the absurdity at Sidcup.

Clive Efford: In outer south-east London, when the proposals in the A picture of health programme were first put forward in October 2007, we were told that they had come from a conference of clinicians, doctors, nurses and midwives who had got together and come up with them. It was on that basis that they were supported. They were reviewed by Dr. George Alberti, who gave them his bill of health, for want of a better expression. The hon. Gentleman says that he is not in favour of top-down planning for our local NHS services, but if our local clinicians have drawn up the proposals, what is the basis of his objections?

Andrew Lansley: I can tell the hon. Gentleman this in one sentence: he should go and talk to his local GPs. I have talked to representatives of the GP community across London, and they share our concerns about the nature of this process and about many of the assumptions that seem to underlie how it will be pursued.

Several hon. Members: rose -

Andrew Lansley: I will give way to my hon. Friend the Member for Hornchurch (James Brokenshire), but then I must finish my speech.

James Brokenshire: We have heard about the proposals being clinically led, but does my hon. Friend agree that some of the decisions have been made purely on the basis of private finance initiative contracts? The focus has been on hospitals with large PFI contracts. In north-east London, the focus is on centring everything around the Queen's hospital and putting more pressure on it, and in south-east London, non-PFI hospitals such as Queen Mary's hospital in Sidcup are effectively squeezed out. The focus is not on health care, but on finance and those PFI hospitals alone.

Andrew Lansley: My hon. Friend is absolutely right, and has a unique perspective in that he sees the problem from both sides of the River Thames. I defer to him because he is responsible for the care of my parents in Hornchurch.
	It is astonishing that nowhere in the NHS London document does it say anything about the cost of establishing those polyclinics. In constrained financial circumstances, how absurd is it to spend million pounds shutting down hospital services only to spend millions more opening new polyclinics, sometimes on the same premises, as at the King George in Ilford? What kind of an absurdity is that?

Andrew Slaughter: rose-

Barry Gardiner: rose-

Andrew Lansley: I will not give way, if the hon. Gentlemen will forgive me. Mr. Speaker will not forgive me if I do not make progress.
	I have one final point to make. Members from across London feel a similar way about the proposals, the assumptions that are being pursued, the lack of evidence, and the inability of NHS London to justify what it seems to expect will happen. In their amendment, Ministers are saying, Look, don't worry; it'll be fine. Nothing will happen until the other services are already there. Ara Darzi said last year that there would sometimes need to be double-running to enable the plan to be established, but he has gone, and that plan seems to have disappeared.
	I must tell Labour Members that the Government's amendment is not justified: there is no plan in any of the sectors to establish services in the community and get them up and running, or for a shift in activity away from hospitals, before the point at which hospitals are shut down.

Susan Kramer: Will the hon. Gentleman give way?

Andrew Lansley: No.
	Page 20 of the January 2010 document says:
	Implementing Healthcare for London means a considerable shift in activity from acute to polysystem settings. Unless any surplus capacity can be exited quickly-
	which I think means shutting hospitals-
	there will be significant double running costs. Developing proposals for service change, consulting stakeholders on those proposals and implementing agreed service changes takes too long and is expensive. A speedier approach to reconfiguring services needs to be developed.
	There we have it. The Government's amendment is not what NHS London is setting out to do: that is in black and white in NHS London's document. It says, We don't want double-running costs; we want to be able to shut hospitals down quickly, and a speedier way of doing that-but that is not what is in the amendment. I urge the House to support the motion and fire a shot across NHS London's bows.

Mike O'Brien: rose-

Mr. Speaker: Order. Just before I call the Minister to move the Government amendment, I simply state-I think all hon. Members know this-that the longer the speeches from the Front Bench, the fewer opportunities there will be for those sitting on the Back Benches. To move the amendment in the name of the Government, I call the Minister.

Mike O'Brien: I beg to move an amendment, to leave out from House to the end of the Question and add:
	recognises that there are health inequalities, particularly around heart disease, stroke and cancer, to be addressed in London; agrees that there is a need to build stronger organisations which are clinically and financially sustainable and provide the best service to their local populations; recognises the importance of the work by Lord Darzi and over 200 clinicians who undertook the Healthcare for London review, which was widely supported and consulted on in London; recognises that trusts have worked closely with their local communities to communicate the aims of the programme; further recognises that lives will be saved because the NHS in London, supported by public consultation and following review and scrutiny by local and pan-London Health Overview and Scrutiny Committees, has agreed to implement new stroke and trauma networks surrounding world-leading major trauma centres and hyper-acute stroke units to ensure that patients receive high quality and innovative care in centres of excellence, expected to save approximately 500 lives a year; acknowledges that there have already been improvements in cardiac outcomes; notes that there must be no further changes to accident and emergency or obstetrics departments unless and until improved access to new services is available and that any changes must be subject to full and formal public consultation; and further notes that the Government is preparing robust planning systems to ensure that NHS London is fully prepared to meet the challenges posed by the London 2012 Olympic Games..
	In opening, the hon. Member for South Cambridgeshire (Mr. Lansley) took 24 minutes. [Hon. Members: Thirty-four minutes!] I apologise. Perhaps I was more generous to him than I should have been. I normally take a lot of interventions, as the House will know, but I will try to make some progress today, because I am conscious that many hon. Members will want to raise their local concerns about NHS London.
	I had a lot of sympathy with the hon. Gentleman's comments on inequalities, and with the motion, which is about a number of those. There is common ground on the need to address those inequalities. The difficulty is that the motion, and indeed his comments, identify a series of problems but offer no possible solution. I can see the opportunist, pre-election attempt to wrong-foot Labour, but the motion and the speech offer no vision, no new ideas, and frankly no agenda for government. They expose the Conservative party as offering no constructive way forward to address the very problems that the hon. Gentleman and his motion identify. We know that there are inequalities in stroke provision, and in heart provision. We know that London has worse outcomes and greater inequalities than other parts of the country. We know that lives are lost because of the current disposition of services. We know that infant mortality rates in Haringey are three times those in Richmond. We know that life expectancy deteriorates by a year for every stop on the Jubilee line from Westminster to Canning Town, from 77 down to 70. There is an over-reliance on A and E because GP practice in deprived areas in some parts of London is inadequate. But the best that the hon. Gentleman can offer is a vague view that we should leave it up to GPs to solve it through their budgets. He says that GPs should put more money into services if they want to keep them, on an ad hoc basis and without any process. That is an abdication of responsibility.

Emily Thornberry: Is my right hon. and learned Friend aware that NHS Islington is currently engaged in a so-called pre-consultation about the future of our greatly loved Whittington hospital? That so-called consultation is as chaotic and incoherent as it is alarming and wrong. Will he instruct NHS Islington to listen to local MPs and the public and dismiss any suggestion that Whittington A and E and maternity unit should close?

Mike O'Brien: As my hon. Friend knows, I have said in a debate on the Floor of the House in December that I have concerns about what is happening in relation to the Whittington. She has fought a strong fight on the issue and spoken to me about it on several occasions. We need to see strong clinical evidence for any change to the status of the Whittington. It is being discussed locally, but the national clinical advisory group will need to look at any case put forward. It is local now, but we have invested £32 million in the Whittington, much of it in A and E, and unless the case for change is established, there will be no change. At the moment I am not convinced of the need for the Whittington A and E to close. Those discussing these things need to know that. I have serious concerns about it and I would want to see a serious clinical case made for saying that the £32 million that the Government have decided to invest in the Whittington should be overridden. I do not see any justification for closure of the A and E at this time, and I would want to hear the case for closing it during the next Parliament. I have seen no such case.

David Burrowes: Is there any prospect of any change from this Government to the decision to downgrade Chase Farm hospital's consultant-led A and E and maternity services despite more than 100,000 attendances at A and E and more than 3,300 births at the hospital?

Mike O'Brien: We are looking with great care at all the various proposals and Chase Farm hospital is the subject of one of those proposals in London. The issues are supposed to be locally driven, locally led and locally determined reconfigurations. The hon. Gentleman and his party seem to think that this is all coming from Whitehall, but that is complete nonsense. These are local decisions, locally arrived at.

Jeremy Corbyn: I thank my right hon. and learned Friend for his reply to my hon. Friend the Member for Islington, South and Finsbury (Emily Thornberry). The overwhelming case for retention of the Whittington A and E has been made and continues to be made, but we discover that officials from the north central London NHS review are still working on a plan that we believe involves closure of the A and E, and they will not publish that plan for several months. Will he ensure that all the plans are published now so that the public can see what is being thought up by officials?

Mike O'Brien: If my hon. Friend will forgive me, I want to return to the various discussions that have taken place, the minutes and the proposals being circulated. Engaging with clinicians, and how we engage with them, is important.

Lynne Featherstone: rose-

Mike O'Brien: I will give way to the hon. Lady, but then I want to make some progress.

Lynne Featherstone: I welcome the Minister's remarks because, as he knows, the socio-demographic circumstances around Whittington hospital make the area one of the most deprived in London. My concern is that, of the seven current options, four suggest closing the accident and emergency department. That seems to be a huge waste of resource and energy when the money is needed in front-line services. Will he talk to north central London officials now and stop the process, because, as the hon. Member for Islington, North (Jeremy Corbyn) said, the case has been made for retention of the A and E department?

Mike O'Brien: I hear what the hon. Lady says, but if she reads my comments just now and listens carefully, she will realise that, in a sense, I have addressed some of those points already.

Theresa Villiers: rose-

Mike O'Brien: If the hon. Lady will forgive me, I need to make some progress; many people want to speak in the debate.
	I do not mind the hon. Member for South Cambridgeshire taking the view that he does not like the Darzi process of clinically led, locally driven decisions made through a local process. He can object to that. We have set out a broad-based approach, and a decision-making process, as a result of a review by clinicians. I do not mind him objecting to that, and he is perfectly at liberty to do so-it is a matter of debate-but I find it bizarre that his alternative is no alternative. It is a Stop the bus, I want to get off approach. He is saying, There are lots of inequalities in London, and lots of issues that need to be addressed, but I'm not going to address them because they are in the 'too difficult' category.
	For decades, reconfiguring London to deliver better services has been in the too difficult category for too many Governments. Virginia Bottomley attempted to do it, but got hammered for it, because it was not clinically led. As a result, Londoners have put up with a worse service than many other parts of the country. Decisions about changing the NHS are difficult, and people are attached to local provision and fear changes. After the Thatcher period, they fear that the agenda is about cutting provision, not about making it better.
	Going back decades, Governments-Labour and Tory-have failed. In 2006, NHS London asked Professor Ara Darzi-now Lord Darzi-to set out a vision for change in London: a process for bottom-up, clinically led improvements, the aim of which was to drive up the quality of services, not to make cuts. Because Ara Darzi was an eminent consultant-not a politician or a manager-clinicians bought into the process. They accepted his bona fides and his work to improve provision, and they engaged in the difficult process of change.
	Discussions about possible reconfiguration have taken place across London- [Interruption.] Yes, they have, and clinicians are still engaged today, but they will not be if the Conservatives get in, because they will stop that process. Clinicians are engaged in a variety of meetings-this comes back to a point raised earlier-considering options and discussing them among themselves before making proposals through an iterative process of asking, What are the best proposals for each area? This is about clinicians discussing what is best for London.
	Those proposals are already out for consultation in north-east London, and elsewhere they are still being discussed and weighed up. Local people will be engaged when there are clear proposals. They will be bottom-up, not Whitehall-led, proposals from the local NHS, not Ministers. That does not mean that it will not be difficult-the proposals raise concerns-but it means that clinicians concerned about quality services are leading the process. The key Darzi components can be summarised as localised services where possible, and centralised services where it is necessary for patient safety.
	That is the process that the Conservative party is attacking and saying that it would do away with. Its motion identifies the problem in London, but rejects the bottom-up reconfiguration that clinicians say is needed to save lives. Instead, the Conservatives would dump the Darzi process, opportunistically attack every output from it and every attempt to allow clinicians the space to discuss what would work, play on the fears of local people, and, most damagingly and opportunistically of all, offer no real process to replace it.

Joan Ryan: rose-

Theresa Villiers: rose-

Simon Hughes: rose-

Mike O'Brien: I will give way to the hon. Gentleman in a moment.
	The NHS changes are difficult, and they do raise local concerns. If there is a real alternative to what we are doing-if the hon. Member for South Cambridgeshire had come up with anything other than saying, Let the GPs decide from their funding what they want to keep and what they do not-then I missed it. He did not come forward with any such alternative: it is not in his motion and it was not in his speech.
	Let us have a look at the motion. There is a vague call for something called a
	public health strategy geared towards the reduction of health inequalities.
	Yes, good-got that. Indeed, Darzi attempts to do just that, but if the hon. Gentleman does not accept the Darzi process, what will he put in its place? A policy of no-change conservatism is not a serious policy. It does not deal with the inequalities that the hon. Gentleman set out. People are now dying and getting poor health treatment because Governments in the past have found the problem too difficult. We are now making some of the changes that are needed. In the face of that, the Conservatives abdicate responsibility, advocate nothing to replace the Darzi process and play to public fears. That is what is happening. If they do that in government, the inequalities that the hon. Gentleman has identified will remain, because he has no approach to deal with them. All he wants to do is play Pontius Pilate, washing his hands of the problem and saying, Well, we wanted something done-there were real inequalities-but it was up to the GPs locally.

Simon Hughes: Does the Minister realise that the reason why a lot of people are fearful and suspicious is that they have recent memories of reorganisations? The Tories proposed, and Labour then agreed, to the closure of the A and E unit at Guy's hospital, for example. Money has been allocated to primary care trusts in deprived areas such as Southwark, but it has then been top-sliced and taken away, even though we were meant to need and deserve it. I can tell the Minister that we have wards in hospitals across the river from this place, including in Guy's, that are absolutely full and overstretched-and not full of not ill people, but full of seriously ill people who need to be in hospital, not treated by their GP.

Mike O'Brien: It is the case that Government funding for the NHS has, of course, increased massively over the past decade, as the hon. Gentleman well knows.  [ Interruption. ] It has increased, and it is also the case that London has received substantial amounts of additional funding, and will continue to do so this year and the next. We need to ensure that that money is spent in the best way possible, so that we deliver the best quality of services and deal with the inequalities in London. At the moment that has to be done by engaging clinicians in a serious process of looking at what works and at how we can change the services, so that we address those inequalities effectively.
	My concern is about the intellectual hole in the Opposition's policy. They would end the process that we have set up, and although I think that they genuinely want to will the end of having to deal with inequalities, I just do not think that they have any means to deliver that-they have not come up with anything, anyway. Frankly, from what I can see in the speech by the hon. Member for South Cambridgeshire, their priority is marginal seats, not saving lives. Their worry is about parliamentary candidates, not stroke victims. If they offered an alternative, there would be a debate, but how can we debate with someone who offers no alternative but to return the health of London to the too difficult column? That is what the hon. Gentleman is doing: no courage, no leadership, and, most worryingly for a possible alternative Government, no vision for how to solve the health problems of London.
	Let me explain why we believe that London must change and how that can be done.

Andrew Slaughter: Will my right hon. and learned Friend give way?

Mike O'Brien: I will, and then I will make some more progress.

Andrew Slaughter: My right hon. and learned Friend correctly identifies the fact that the Opposition speech was about politics, not health. There was a certain irony in the hon. Member for South Cambridgeshire (Mr. Lansley) denouncing scaremongering by the Liberal Democrats, but then entertaining every piece of scaremongering from those on his own Benches, including, in relation to north-west London, the complete fabrication that hospitals in the Imperial College Healthcare NHS Trust will close, which the hon. Member for Hammersmith and Fulham (Mr. Hands) used in order to get elected five years ago-he said that the hospital was going to close, but it is bigger and better resourced than ever. Will my right hon. and learned Friend confirm that there are no plans-

Madam Deputy Speaker: Order. Interventions are to be brief.

Mike O'Brien: Our former hon. Friend, Keith Bradley, found that a campaign was run about a supposed hospital closure in Manchester, and he lost his seat. These are potent arguments, and I can see that opportunistic politicians might run scare stories. That is what is being done. We are trying to undertake the serious process of addressing some of the very inequalities mentioned in the motion on which Opposition Members are going to vote. We have clear proposals for dealing with them, but the hon. Member for South Cambridgeshire has no such proposals at all.
	Eleven out of 32 London boroughs are classified as spearhead areas. They are the most deprived areas with the greatest need, and the case for change is clear. Money is not enough, but it certainly helps. Over the past decade, there has been unprecedented extra funding. As a result, the number of people waiting more than 26 weeks for in-patient care has fallen from 48,849 in 1997 to two in January 2010. That is still two too many, but it is a staggering achievement. In January, only three people waited more than 13 weeks for an out-patient appointment. That figure is down from 43,639 when we came to power.
	The NHS in London has come a long way by having more money. Money alone is not enough, but it helps. This year, the PCTs in London will receive £13.2 billion. Next year, they will get £13.9 billion. The hon. Gentleman asked what we got for that money. There are 45,000 more staff in the London NHS than there were in 1997, and I should just mention that there are 3,000 more consultants, 18,000 more nurses, 1,500 more midwives, and 4,000 more doctors in training. I have a long list, but before I get completely carried away, I shall give way to my right hon. Friend the Member for Enfield, North (Joan Ryan).

Joan Ryan: The Minister will know that Chase Farm hospital is a very good and much-loved, much-needed hospital. The changes to the hospital were decided on before, and outside, the Darzi review. We know that the Conservatives have said that they would make no commitments. They are hypocritical in criticising changes while making no commitment to do anything different. In the light of the achievement of a 24-hour doctor-led service for 2013, will the Minister agree to meet me to discuss further why it is so important to keep an ambulance service at the accident and emergency department at Chase Farm hospital?

Mike O'Brien: rose-

Madam Deputy Speaker: Order. I understand that the temperature is rising on both sides of the House, but may I advise Members to be aware of their language and, in particular, of the use of the word hypocritical?

Mike O'Brien: I am very happy to meet my right hon. Friend to discuss the ambulance situation and to look at the way in which the services in her area are being dealt with. She has spoken to me on many occasions about the issue, and I am familiar with the local circumstances that she faces. She is also right to say that the hon. Member for South Cambridgeshire can give no real commitments on these issues. After all, if he is going to rely on the local PCTs-all 31 of them-in London to make decisions locally, and if the only extra funding is to come from GPs' budgets, he is not going to be in a position to make any commitments on anything, is he?
	We, on the other hand, are making a commitment to an increase of £700 million at a time of financial restraint. Why? Because Labour prioritises the NHS. London now has the biggest hospital building programme in the history of the NHS, with 28 new schemes worth £1.8 billion already open to patients, and another three, worth £1.2 billion, under construction. The Royal London, with a £1 billion scheme, serves some of the poorest communities in London. University college hospital's scheme is worth £422 million. King's college hospital's is worth £76 million. The scheme at Lewisham hospital is for £72 million, and Guy's and St. Thomas's is for £50 million. These are massive enhancements from Labour for London.
	In the community, the NHS local improvement finance trust scheme has led to 45 new developments in London, worth £371 million. Gracefield Gardens centre in Streatham, the Barkantine in Tower Hamlets, which I have visited, the Heart of Hounslow practice, and Alexandra Avenue health and social care centre in Harrow are all shining examples of the results of our investment in the health of our capital. All offer extended opening hours to patients; all offer a wide range of community services in addition to GPs; and all are delivering what patients tell us they want the NHS to do for them-local services in their local area.
	Today, advances in medicine and technology mean that more and more patients can be treated and cared for in the area. We need to ensure that the type of care services people get are those that they need. That means change. It is not about freezing services in aspic, as the hon. Member for South Cambridgeshire suggests he can do-it takes vision, not the policy of NHS do-nothingism. The NHS in London can continue to do better for the people of London. That is why we have set out the Darzi agenda to make some of these changes.
	Across the city, the NHS is looking at how best to implement this programme for improving the health and lives of Londoners. It is already concentrating specialist care in centres of excellence. Londoners who suffer heart attacks are now taken straight to the specialist care they need in one of eight heart attack centres, significantly improving their chances of recovery. Creating that was not easy; it took tough decisions. If we had left it to local PCTs, we would not have had a process. It is because we created the Darzi process that changes were made, addressing local fears rather than stoking them up for votes.
	Last year, a joint committee of all PCTs in London agreed to new stroke and trauma networks based on that model, which will save hundreds of lives. That was fully endorsed by a joint overview and scrutiny committee of all 32 London boroughs, including the Conservative authorities. London's PCTs have invested £20 million in improving stroke care. In the coming months, eight new hyper-acute stroke units will open and standards will be up to the best in the world.
	We are in the process of creating in London a world-class NHS, whereas the hon. Member for South Cambridgeshire has a do-nothing view of the NHS, which will change little or nothing. We also have three new trauma centres, which will be open by April, and that of St. Mary's is to open in October.
	Ten new polyclinics are open, all of which are receiving excellent feedback from patients. An evaluation project is under way to ensure that the local NHS learns lessons so that the model of care can be improved and rolled out across the capital. By the end of the next financial year, another 20 will be in place. Following Lord Darzi's review, the challenge for local areas is to improve services in the most appropriate way for their communities.

Iain Duncan Smith: rose-

Mike O'Brien: If the right hon. Gentleman will forgive me, I have said that others want to speak. I want to make progress as I need to get through my argument. After that, I may give way to him.
	This Government are committed to empowering people to make those local decisions. We believe that decisions about how to provide local health care should be led by local clinicians in collaboration with patients and the public, not by diktat from Whitehall. That is not what we are doing, yet the hon. Member for South Cambridgeshire thinks that adopting any strategic view about how to deal with inequalities is diktat. I say that it is simply having a strategy. That is precisely what is absent from Conservative policy-any sense of strategy or of moving from many to fewer inequalities. There is nothing. That is an indictment of the Conservatives' approach.
	Hundreds of the best clinicians across London are now working together to transform health care in this capital by talking through ideas, which this process provides the space for them to do. I know that there are concerns about the need for more openness in the process. The Liberal Democrats have called for the release of all documents, as we heard. Clinicians do complain a bit about too much sunlight, however. PCTs are working with clinicians to identify options for improving services. If some A and E services close, it will be because clinicians on the ground deem it in the best interests of patients-and never before the alternative services are up and running. Those alternatives have to be there and they have to be better before any change happens. Any changes will always be consulted on prior to implementation and the results of that consultation will be independently evaluated wherever there is a legitimate challenge.

Iain Duncan Smith: rose-

Mike O'Brien: Before I end my speech-I think it is time that I did-let me give way to the right hon. Member for Chingford and Woodford Green (Mr. Duncan Smith), because I promised to do so.

Iain Duncan Smith: I am grateful to the Minister for giving way. This is not a party-political point: I believe that Members on both sides of the House agree with it. The fact is that, currently, decisions are being made and then driven through on the ground by officials who are determined to hide much of that process from Members of Parliament and the public. There is a good example of that in my area.
	Whipps Cross University hospital bid for the stroke and trauma centre, having a good stroke centre itself. It was told that one of the two centres in our area had been awarded to the Royal London hospital because it was close to cardiac services, while the other had gone to Queen's hospital, not, suddenly, because of the availability of cardiac services-Queen's does not have any-but for reasons connected with neurological services. Then it was told that in any event it would not have been able to complete the process in the time available. When we checked, we found that Queen's could not have completed on time either, but had been allowed extra time. In other words, the decision was made long in advance that Whipps Cross would not be given the centre, but as those who had made the decision could not say that, they went through a rigmarole of consultation that was an utter nonsense.

Mike O'Brien: The right hon. Gentleman wants to be non-party-political, so let me be non-party-political as well. We need to ensure that the process is clinically led and locally decided-

Iain Duncan Smith: It was not clinically led.

Mike O'Brien: Perhaps the right hon. Gentleman will stop shouting at me from a sedentary position and listen to what I am saying. As a former leader of his party, he does himself no service by reacting in that way. I am trying to respond to a genuine question in a genuine way. Let the vibrations settle a bit, eh?
	It is important for the Darzi process to be led by local clinicians and not driven by managers following a purely financial agenda.  [Interruption.] Will the right hon. Gentleman calm down and let me finish? If he does that, I will even let him intervene again.
	We need to ensure that the process is driven by clinicians and not by finances. Finances are an important consideration, but the No. 1 priority in the health service must be patients' safety and the quality of care given to patients, particularly in a place like London in which there are massive inequalities. Then we need to ensure that the process is delivered within a budget. That should be the order of priorities. Managers need to be aware of that, and they also need to be aware that it is the views of clinicians that we will consider when we have to examine any proposals that are submitted. We will have them nationally examined by clinicians to ensure that the right clinical judgment is made. If local decision making and the budgets of GPs determine whether or not something happens, there will be no such overview of whether developments are clinically driven.

Iain Duncan Smith: The only reason I gave that example was that it was clear that a decision had already been made, and that those who had made the decision had simply gone through a process of changing the criteria throughout. The point that we are all making is that none of this is being done other than completely in secret. The process must be opened up to clarity in order for proper consultation to be possible.

Mike O'Brien: I agree that the process needs to become much more open. Darzi said very clearly that people did not need to be treated in hospital unless that was absolutely necessary, and that they should be treated as close to home as possible. When it comes to working out how that should be done, clinicians should be at the heart of decision making. That is what is happening across the city. Change is coming. The NHS must invest more in preventive care, rather than waiting until people become unwell. The money needs to be identified. The NHS must give the best possible treatment to those who are very ill, concentrating specialist expertise in centres of excellence. That is what we want to be delivered.

Tom Brake: Will the Minister give way?

Mike O'Brien: I will, but then I must end my speech.

Tom Brake: The Minister has talked of his vision. I know that part of his vision for London is the Better Healthcare Closer to Home programme. We are expecting an announcement from the Treasury confirming that the programme can go ahead. Is the Minister in a position to tell us that it has been given the green light?

Mike O'Brien: I think we are still on an amber light. I am still very hopeful that a green light may well at some point be able to be flashed on. However, I cannot give the hon. Gentleman any firm commitment just yet, but he has made representations to me.
	The hon. Member for South Cambridgeshire has moved a motion on which the House will vote. I give him credit for knowing the NHS well, but that is why I am so concerned with the motion's vacuity. He accepted stroke reconfiguration in Cambridgeshire because he knew that it was necessary and it was clinically led. The indictment of him is that he knows that the Darzi review is right but it is politically difficult. It requires courage to change London's NHS and save lives, and for there to be a credible alternative Government, there needs to be an Opposition party that comes up with a credible alternative if it criticises Darzi. Change is always difficult, but across the country the hon. Gentleman has not opted for the process of improving the NHS; he has taken the opportunist line.
	Let us examine where we have made changes. The hon. Gentleman knows well that the NHS in Calderdale and Huddersfield has reconfigured its maternity services and is giving mothers and babies safer care, but his party would reverse that. In Manchester, the reorganisation of paediatric services is giving children safer, better care, but it appears that his party wants to overturn it. In Birmingham and Sandwell, the new hospital would not be there and patients would not be getting safer, better care without change, but his party opposes change in that area.
	Change is difficult: it requires courage and judgement. In each of the cases I mentioned the Government have made the judgment and have made the change. We have had the courage to lead. We have created a bottom-up process that saves lives. The hon. Gentleman is committed to reversing that for the sake of political expediency, thus sacrificing patients for marginal seats. The clinicians wanted change to save lives and improve the quality of care. He wanted votes, and he seeks to obtain them by scaring people into a conservative view on opposing change.
	I do not deny that it is easy to scare people and that seats can be won in that way-that has been done-but leaders do not do that. People who care about the NHS do not do that. We have not done that; we have made the change, we are improving the NHS and as a result of those changes we are going to be saving lives that will, if this process is stopped, be put at risk. We are prepared to make the change; the Conservatives are not the change.

Norman Lamb: The Liberal Democrats welcome this debate on an incredibly important issue for the people of London. However, it is fair to say that the Conservative motion does not really achieve very much, because all it calls for, in effect, is a delay in the reconfiguration process until there has been more effective public consultation.  [Interruption.] Well, that is exactly what the motion says. We have not even got to the point where the public consultation is built into the process, because we are told that that is due to take place this autumn. Our criticism of the process is much more fundamental than that.

Andrew Pelling: Will the hon. Gentleman give way?

Norman Lamb: Not quite yet. I am only 30 seconds into my speech.
	Our criticism is of the way in which the NHS makes decisions and the fact that they are taken by bodies that are completely unaccountable to the people they serve. The Minister made two assertions in his speech. The first was that these decisions are local decisions. Who are these local decisions taken by? They are taken by people who have no legitimacy; they have been appointed nationally, so there is no accountability to the communities-

Clive Efford: Will the hon. Gentleman give way?

Norman Lamb: I shall in a moment, but let me finish my point. There is no accountability to the communities that they serve.
	The Minister's second assertion was that the whole process is clinically driven, but we know that that simply is not the case. I wish to refer to an anonymous e-mail that I received from someone who describes himself as
	a (traditionally Labour voting) commissioner working in the sector
	in north-west London. He refers to the fact that the clinicians have been
	either left in the dark or openly hostile.
	This is a process that is clinically led, but very much the opposite is in fact the case. The process almost seems designed to alienate the public and the clinicians who are desperately trying to provide services. My hon. Friend the Member for Kingston and Surbiton (Mr. Davey) has referred to conversations that he has had with local clinicians who are deeply frustrated by what is going on. They may have been involved in the process, but they do not want it and they are not leading it in any sense of that word.

Andrew Pelling: I want to congratulate the hon. Gentleman and his colleagues on opening up the debate by having the courage to talk about this matter publicly. Is it not right that such a debate should take place during a general election, and not be postponed by the Conservative party or Labour party until afterwards, when patients' influence will be minimised?

Norman Lamb: The hon. Gentleman makes absolutely the right point. It would be scandalous if any of the related papers were kept secret until after the general election. There almost seems to be a conspiracy of silence to prevent the public from knowing the real facts until after the general election.
	The process seems designed to destroy confidence and to engender suspicion about motives. We know that the real pressure comes from the financial crisis faced by the NHS, which is in large part due to the way in which money has been spent by this Government within the NHS. I shall come on to one of the particular reasons for that-PFI, which was mentioned a while ago by an hon. Member on the Conservative Back-Benches.
	An opinion piece in  The Guardian on 3 March stated that
	proper discussion about the future of vital public services is being stifled because profound changes-in London and beyond-are accompanied by secrecy, obfuscation, double-speak and concealment by the NHS at almost every turn.
	There is a culture of fear-people fear the consequences of speaking out. That Labour-voting commissioner from north-west London writes that he wants his e-mail kept anonymous. He does not give his name, because he fears that his job would be threatened
	were I to be linked to sending you this material.
	What an indictment it is of the NHS under this Government that people fear for their jobs if they speak out and reveal to the public what is going on behind closed doors. He says in that e-mail that there has been produced in north-west London
	a long list of fantastical figures about the number of outpatient appointments, emergency admissions and diagnostics to be moved out of hospital and into 'polysystems' in the community. The idea is to move 55 per cent. of everything, even though the infrastructure and ability of the NHS outside the hospital to cope is not credible.
	He goes on to talk about how the acute commissioning vehicle has emasculated the primary care trusts-the bodies that are supposed to be there under this Government to determine health care for their local communities. They have been emasculated by this new body that is imposing its decisions on the local area. Clinicians have been kept in the dark and feel completely excluded from the process in many cases.

Andrew Slaughter: The picture that the hon. Gentleman is painting comes from tittle-tattle and innuendo. I represent a seat that is covered by the north-west London sector, and the picture that he paints bears no resemblance to the truth on the ground. All that people have seen for the past five years has been an improvement in the quality of their health services, whether at a polyclinic level, a tertiary level or in the three hospitals that make up the Imperial College Healthcare NHS Trust. He ought to pay some tribute to the work that is going on in the health service in those areas instead of simply spreading despondency on the basis of rumour.

Norman Lamb: The hon. Gentleman refers to the views of a commissioner from north-west London as tittle-tattle and innuendo. I shall tell him a bit more of what that commissioner says:
	The result is ever increasing centralisation, and clandestine plans for the complete closure/downgrading of sites such as Ealing Hospital, West Middlesex Hospital and others.
	The acute commissioning vehicle
	are telling us that there will be only 2 major hospital sites left in NW London, with threats to move all specialist services from others such as CW Hospital, Central Middlesex, Charing Cross, Mount Vernon, Hammersmith, Hillingdon and possibly Royal Brompton and Royal Marsden.
	That is the view on the ground from a commissioner working in the NHS in north-west London. The hon. Gentleman might not have received the leak, but that is the view the commissioner has expressed from the coal face.

Clive Efford: The hon. Gentleman surely cannot base his argument entirely on one anonymous e-mail that he claims to be a leak. We have all had concerns about the proposals in south-east London, but they were put forward in the autumn of 2007 as a result of a conference held by clinicians-doctors, nurses and midwives. They came up with them and it was on that basis that NHS London decided to move forward on the proposals, which were also reviewed by Professor Alberti on a clinical basis. On what does the hon. Gentleman base his argument that the proposals have nothing to do with local practitioners or local decision making?

Norman Lamb: I have expressed the view from north-west London, but we have heard other stories from north-east and south-west London, and I shall come to those in due course.
	The origin of all this was a report that NHS London commissioned from McKinsey's, which has remained a secret to this day. Surely there can be absolutely no justification for that. The Minister has said that this process should be more open, so will he commit to publishing that report? I give him the opportunity to intervene. Will he publish it today? That is what people want.

Mike O'Brien: I am grateful to the hon. Gentleman for that invitation, but I have not seen the McKinsey report to which he refers. It has not landed on my desk and I have not got-

Norman Lamb: Do you think it should be published?

Mike O'Brien: Well, no; it is not mine to publish. I cannot commit to publishing-

Norman Lamb: But do you think it should be published?

Mike O'Brien: Madam Deputy Speaker, I am being heckled from a sedentary position by the hon. Gentleman who has allowed me to intervene on him. Perhaps if I give the floor back to him, he can heckle me a little more.

Norman Lamb: I do not know what to take from that. I do not know whether the Minister believes that the report should be published. It might not be his to publish, but he could at least indicate to NHS London that the Minister with responsibility for this sphere believes that it should publish the report. That would be very helpful. Is he willing to do that?

Mike O'Brien: I am grateful to the hon. Gentleman for again inviting me to respond. I do not know what is in the report in the sense that I have not read it. I do not have a copy, so this is a matter for NHS London to deal with, but I am sure that Ruth Carnall, the chief executive, will have heard his comments. I am not going to order her to publish it, no, but I shall ask her about it.

Norman Lamb: I am pleased that the Minister will at least ask her about the report, because, as he said earlier, this process should be open, but it is certainly far from that. These are our local health services and our taxes that are being spent, so we deserve to know what is being planned behind closed doors. We demand disclosure.
	We presume that the Conservatives know about the report because one of their parliamentary candidates works in McKinsey's health team, so they are presumably party to it. Meanwhile, the public and clinicians are kept in the dark. I ask the Government to commit to bringing into the public domain, before the general election, the processes that are taking place around the country, in every strategic health authority, so that people can cast their vote in the full knowledge of what is being planned behind the scenes.
	Those who reveal plans to the public are accused of scaremongering. My hon. Friends the Members for Kingston and Surbiton and for Richmond Park (Susan Kramer) rightly decided to inform the public of what they have been told and about draft reports that they have seen regarding threats to their local hospital, but the Conservative shadow Minister, the hon. Member for Hemel Hempstead (Mike Penning), accused them, in an Adjournment debate, of scaring the public. The Conservative view seems to be that these issues are best kept secret and that they should not be revealed to the public until after the general election, which is outrageous. I applaud my hon. Friends for having had the guts to put that information into the public domain so that the public can know what threats exist.
	The threat is real. I have a copy of a draft report entitled Presentation to NHS Kingston Joint Board and PEC meeting, which confirms that one in three of its 18 options would involve the closure of Kingston hospital's maternity unit, accident and emergency unit and paediatric in-patient department. Sixteen of the 18 options would see Kingston lose a significant service from that hospital. My hon. Friends deserve an apology from members of the Conservative Front-Bench team and local Conservative campaigners. They have been accused of scaremongering, when the matter is in black and white.
	Interestingly, the report ends with a note saying that it should be sent to NHS London but not published. My hon. Friends have got it into the public domain, and they made the right judgment in doing so. These are decisions of which the public should be fully aware.

Mike O'Brien: I am a little confused by the point that the hon. Gentleman is making. He referred to the hon. Member for Kingston and Surbiton (Mr. Davey), who was busily telling us about these changes on his website on 5 October. Having talked about how good it was that public meetings were being held, he concluded by saying:
	For my part, I'm excited about what I've heard. I've been critical of the local NHS in the past, but this time the ideas look good.

Norman Lamb: rose-

Edward Davey: Will my hon. Friend give way?

Norman Lamb: I am very happy to.

Edward Davey: I am very grateful to my hon. Friend, as I want to explain to the Minister what I was talking about on the website. I was talking about proposals for polysystems, and about the fact that Kingston NHS was building a polyclinic at Surbiton hospital. My support for that polyclinic remains, and I also supported the changes to stroke and cardiac services that came from NHS London. What we oppose are these secret changes, with one option in three proposing that our local hospital should lose its A and E, maternity and in-patient paediatric services. The fact that the Minister does not understand that does him no favours.

Madam Deputy Speaker: Order. A great many people wish to contribute to the debate, so I would ask that interventions please be as they should be-brief.

Norman Lamb: Thank you very much, Madam Deputy Speaker, and I am grateful to my hon. Friend for that explanation.
	I was referring to the proposals for north-east London, which emerged only because my hon. Friend the Member for Hornsey and Wood Green (Lynne Featherstone) received a leaked letter from a clinician in the system. Again, the letter demonstrated what was going on but was kept from the public. It set out options, including the potential loss of A and E and maternity services at the Whittington hospital. The hospital is much loved and needed, and it serves one of the poorest communities in the country. The area has one of the lowest rates of car ownership in the country, yet it is proposed that those services should be lost. Again, my hon. Friend was right to get the matter into the public domain so that people can make their own judgments on the proposals.
	The belief, certainly in north-east London, is that the proposals are not evidence- based, and that wrong assumptions have been made about the potential impact of the loss of an A and E department at the Whittington hospital. People believe that conclusions are being drawn that do not stand up to analysis.
	I turn now to the private finance initiative, which has imposed an enormous burden on the NHS in London.

Iain Duncan Smith: The hon. Gentleman is talking about north-east London, but a year and a half or two years ago Professor Alberti was called in to have a look at the process whereby the various PCTs in the area were going about the business of change. He was highly critical of the secrecy involved, and of the trusts' failure to tell the public exactly what was going on. The idea that the problems were driven by clinicians is absolutely not true.

Norman Lamb: I am very grateful to the right hon. Gentleman for that intervention. It appears that the PCTs have learned nothing from George Alberti's intervention a year ago, as the same secrecy continues to pervade the entire process.
	As I was saying, I shall deal now with PFI. There have been 20 PFI schemes providing new facilities in London at a cost of £2.6 billion, but the repayments over the lifetime of those facilities will come to a staggering total of £16.7 billion. Those repayments have not been properly budgeted for, but they will bankrupt the NHS and in a sense drive the changes that we are debating today.
	This year, PFI payments will amount to £250 million in London alone. By 2014, that will have risen to £400 million per year. That is forcing up overhead costs on trusts and squeezing the resources of other health services. It is also, as the hon. Member for Hornchurch (James Brokenshire) said, distorting decision making about service changes.
	The proposals appear not to have taken sufficiently into account the pressure of rising case loads in London. Many London hospitals find that acute bed occupancy rates are approaching 100 per cent. In other words, throughout the year they are virtually entirely full. The BMA says that the 3.7 million attendances at accident and emergency departments reflect high levels of mobility and temporary residents often unregistered with GPs, who choose to go to their local A and E department because they have nowhere else to go. As the proposals are put forward, there is nothing else in place to reassure the public. It is dangerous to make assumptions about the ability to cut numbers going to hospital before new arrangements and facilities are put in place.
	There should be a recognition that the process is flawed. Consultation, despite the Conservatives' apparent faith in it, will not satisfy the public of London because all too often, as the right hon. Member for Chingford and Woodford Green (Mr. Duncan Smith) suggested, consultation is seen-rightly, in many cases-to be a fait accompli, a rubber-stamping exercise. As the report from south-west London confirms in one of the charts that it contains, the final stage is consultation and implementation, as if consultation is a box that must be ticked before implementation of the changes that have already been determined.
	We have surely tested to destruction the model that seeks to impose change decided by unaccountable bodies. We have the bizarre spectacle now of Labour Ministers leading protest marches against closures in their own local area. Instead, let us start by achieving savings in the NHS by slimming down the central bureaucracy, which has become overblown and entirely out of control under this Government, with 25,000 people working for NHS quangos at a cost of £1.2 billion a year. Let us reform the way that money is used in the NHS to manage those with chronic conditions much more effectively than we do at present, avoiding the crisis admissions to hospital which are so costly to the NHS and so disruptive to patients and their care.
	Let us provide better incentives to prevent ill health in the first place. Critically, let us make primary care trusts democratically accountable to the people they serve. These are services that we all use, and those bodies that make decisions should be accountable to us. It is instructive that two former Secretaries of State from the present Government now support the case for democratic accountability in the decisions relating to the commissioning of health services. Decisions about local services should be reached in as open a way as possible by democratically accountable bodies.
	Chris Ham, who will take over as head of the King's Fund, has cited the process in Sweden, where there are democratically accountable bodies responsible for health care. In Sweden they go about decisions in a collaborative way, involving the public not after the decisions have been taken, but at the start of the process, so that everybody understands the financial constraints that we all accept are there, involving the clinicians and reaching decisions together, rather than imposing them from on high.

Jeremy Corbyn: Will the hon. Gentleman give way?

Norman Lamb: No.
	We want to be able to hold those organisations to account. Until that happens, we will oppose cuts in local services imposed on local communities by people who have no democratic accountability.

Several hon. Members: rose -

Madam Deputy Speaker: Order. Mr. Speaker has imposed an eight-minute time limit on Back-Bench contributions, but in view of the amount of time that has already been taken, after the first two Back-Bench contributions the time limit will be reduced to six minutes.

Frank Dobson: I find it very unconvincing when I hear a Tory Front Bencher speaking in favour of reducing health inequalities. When we came to power in 1997, each part of the country was supposed to be allocated health service funds that reflected the size, nature and health of their population, but the east end of London was getting 23 per cent. less than it was entitled to, and surprise, surprise, Tory Surrey was getting 23 per cent. more than it was entitled to. That is entirely typical of what the Tories have always done.
	In my constituency, investment under the Labour Government has been quite dramatic. We have the new University College hospital, which I freely admit got under way when I was Health Secretary; and we have also had big improvements at the Royal Free hospital, which serves my area, and at Great Ormond Street hospital, which serves children from across the country. We have new health centres, with two in Kentish Town and one that has just reopened in Gospel Oak; most GP premises have been improved; and the survival rates and general performance in our area have massively improved because the buildings and equipment have at long last started to match the excellence of the staff.
	As part of that, there has been a lot of investment in the Whittington hospital. I can remember, when I was in opposition, going to the Whittington and pledging all sorts of things. As I believe in keeping pledges, those pledges have been kept, and a lot of extra money has been invested in the Whittington. I could not get firm figures from the hospital today, but as I understand it £27 million was invested in the new accident and emergency department, so my hon. Friends and I find it slightly bizarre-to say the least-that nameless, faceless people have suddenly appeared on the scene and decided to recommend that the A and E department, in which all that money has been invested, no longer function, and that instead people be diverted to the Royal Free and University College hospitals.
	I checked this morning at University College hospital. It was designed for 60,000 A and E attendees, and it now has knocking on for 90,000, so Lord only knows where the 90,000 people who use the Whittington will go. Apparently, the explanation is that many would go to clinics-new health centres-in Islington. The only trouble is that they have not been built, and it will cost money to build them. So if the closure is being undertaken to save money, it is utterly stupid because it will involve spending money to substitute for the money that has already been spent at the Whittington.

Glenda Jackson: The issue is not only the waste of money, because the Whittington A and E rumours, which are rife in our part of the world, are having a serious knock-on effect on the hospital in my half of the borough of Camden, namely the Royal Free, and that is producing anxiety among not only patients but staff. Surely we have not invested all that money in the national health service and its staff suddenly to make them feel that they are no longer wanted or useful. It must be having an effect on their contribution now.

Frank Dobson: As ever, I agree with my hon. Friend and good friend. The report that was produced on behalf of the primary care trust last week shows how it estimates that between only 10 and 30 per cent. of the people who currently attend A and E could be properly attended to at one of the devolved clinics, as we might describe them. However, up to now the basis of the Darzi report has been that between 50 and 60 per cent. of people could be safely dealt with at such clinics, and I do not agree. I am simply not convinced.
	The whole basis of the concentration of stroke provision and major trauma provision, which I strongly support, is that practice makes perfect, but apparently practice does not make perfect in A and E any more, because the people who have a lot of practice at a large A and E will be substituted by people who have a lot less practice at clinics in the community. So the closure does not make sense in terms of the practicalities or, indeed, the money.
	The idea that there was widespread, successful consultation of Londoners over the whole Darzi thing is really preposterous. About 1,800 Londoners-and there are rather a lot of us-expressed support for the Darzi proposition, and about 1,700 said that they did not want it, so the view was far from unanimous even among those who were consulted. I find that outcome about as convincing as Lord Ashcroft's protestations about his tax status, and we all know what that indicated.
	Unfortunately, these aspects are bringing into disrepute a great deal of the achievements that the Government have brought about in the years that we have been in office. At the meeting I went to, when we had to listen to the burblings of some of the people who are proposing what is happening at the Whittington, nothing much was said about improving clinical performance; it was all about saying, Oh, we think we're going to be £500 million down. When they were pressed to explain how that was going to happen, they could not come up with any satisfactory explanation. I can only assume that they are absolutely convinced that there will be a Tory Government and that there will therefore be a £500 million-a-year reduction in the money that is available, because they could not possibly conclude that from anything that the Labour Government have been committed to.
	We need to look at the functions of NHS London. It is NHS London, not NHRS London: it is there to help clinicians in London to improve the services, not to be a national health reorganisation service for London. A lot more attention needs to be paid to what local people want.
	In talking about A and E, I come back to the thing that I have been obsessed with for all the time that I have had an interest in this issue, and that goes back a very long way-if we want to make A and E departments more successful, let us put some GPs in there to deal with the folks who choose to turn up. People do not want to be told, even by clinicians, that they should not turn up at their local hospital. If they want to turn up for GP services, as well as strictly A and E provision, that should be fine by us, and it would be a proper response to the situation that we face.
	I strongly welcome what the Minister said about being far from convinced of the merits of the closure of the A and E at Whittington hospital. One has to be careful what one says when one is a Minister, and what he said far from overstates the reaction of most people in the area and, according to all my sources, the reaction of most of the clinicians who are working at the Whittington and want to continue to do so. I welcome what he said, and I think he had better press on with it. We cannot leave this to bureaucrats. It is no good leaving things to bureaucrats, because when they get it wrong, they do not have to stand at the Dispatch Box to explain. Ministers have to do that, so Ministers should take responsibility right the way through. The people who take the decisions should carry the can, and the people who carry the can should take the decisions.

John Horam: I never thought that I would stand up in the House and agree with the right hon. Member for Holborn and St. Pancras (Frank Dobson), particularly on health matters, but he made a very important point in his criticism of the Darzi proposals. Having spent millions of pounds on new hospitals in London, the Government now want to make a radical change in favour of treating a huge proportion of the people who currently go to the accident and emergency departments of those hospitals in polyclinics, which have not yet been built and which they propose to build during a period of financial difficulty. It is mad to behave in that way. It is in the same category as the Government's deciding to pay GPs a lot more to do less, and then having to pay them even more to do the things that they were originally supposed to do. All these financial and medical decisions by the Government seem to come from Alice in Wonderland.
	I doubt whether one could find a worse example of what is wrong with the NHS in London than in looking at my own corner of the city-south-east London. There, as my hon. Friend the Member for Bromley and Chislehurst (Robert Neill) has pointed out, we have the South London Healthcare NHS Trust, which was a shotgun marriage between three hospital trusts that had severe financial problems. It was set up with an accumulated deficit of £200 million, and was given an operating target for this year of a deficit of £29.7 million. Since we are near the end of the current financial year, that means that the accumulated deficit is now well over £200 million.
	To be fair to the Government, a new management structure was put in place with the creation of the new trust a year ago. Some members of the Government have accused the Conservatives of scaremongering, but I have not done so about the management of the new trust. Although criticisms by consultants, patients and voluntary organisations, such as the local involvement network, have come my way, I said to myself that I would hold back from criticising the management publicly. One should be a responsible Member of Parliament and recognise that the management of any such huge organisation need time to bed down. However, the fact is that we have now had 12 months and the results are extremely disappointing, as the hon. Member for Eltham (Clive Efford) may well agree.
	It is worrying, for example, that the operations director has already gone by mutual agreement. I now understand that the financial director is also going by mutual agreement, although I have not been able to check that. A new operations director is being put in directly from the Department of Health. As a former Health Minister, I know that means that the Department is worried about the new trust. There are clearly problems in its management.
	As I have indicated, this year's target for the operating deficit will almost certainly not be met. That is a problem, because with generous help from the other parts of London, there is a window of opportunity for the South London Healthcare NHS Trust to pay off its deficit, if it meets its operating targets. It seems as though that may not happen, and the crisis that we face in south-east London will therefore be even greater a year from now.
	As far as I am concerned, there has been no real improvement in the trust's performance for patients since its inception. As Members know, it currently has a norovirus problem that has meant the shutdown of many wards and waiting lists rising. That is a difficulty that many hospitals have had to face, but nevertheless I do not see any improvements in performance.
	The origins of all that are quite clear. First, the Government have thrown money at the NHS in London, as elsewhere, with no idea of reform. The hon. Member for North Norfolk (Norman Lamb) mentioned PFI, and he gave the overall statistics for London. In my area we have two hospitals, which now form part of the South London Healthcare NHS Trust. The construction cost of the Queen Elizabeth hospital in Woolwich was £96 million, but the taxpayer will have to repay £799 million. The new Princess Royal university hospital in Bromley will cost £118 million to construct, and the taxpayer will repay £780 million-seven times the construction cost. As Lord Warner, a former Minister in the Labour Government, has said, the NHS received more money than it knew what to do with.
	Another problem has been top-down political management. Civitas, the consultancy, has said that market reforms have not worked as they should have done, because Whitehall is still exercising too much control. We have had endless and changing targets and endless changes in management. For a period of two or three years, the managing director of the Princess Royal university hospital was being changed every six months at considerable cost. Nobody ever gets sacked at the top level of the NHS. It is astonishing how people appear to perform badly and are removed, but then appear somewhere else in the NHS. No one ever suffers the consequences of poor performance.
	Finally, weak structures are part of the problem. Commissioning has not been valued as much as it should have been, and in many ways, as has already been said, it has been emasculated. Lord Warner-I quote from an article in  The Guardian-has said:
	We had 300 PCTs to begin with. That was insanity...The first thing I did was to cut them down to 150. But I wanted to go further and cut the number to 50 or 60.
	He said, as  The Guardian put it,
	that he was thwarted by the Labour backbenches, who feared they would lose vital services from their constituencies.
	What is the answer? Briefly, the Government must cease micro-managing. Instead, we need to create opportunities for individuals and companies inside and outside the NHS to come up with more effective solutions, and for the Government to act simply as a regulator. We need fewer targets and quangos; we need commissioning to be more professional; we need to encourage a diversity of providers and for groups of professionals, private charities and so forth to be brought into play; and we need more competition. I suspect that efficiency and better patient care will go together.
	The tragedy is that all those things were under way when the Conservatives were in charge of the health service, when we made the split between provider and purchaser. That was the opportunity for those sorts of reform. The Government, including the right hon. Member for Holborn and St. Pancras (Frank Dobson), with whom I might disagree on this, set back the whole process of reform. It is a tragedy that 13 years have been largely wasted.

Several hon. Members: rose -

Mr. Deputy Speaker: Order. I remind hon. Members that the time limit is now reduced to six minutes.

Jeremy Corbyn: I am delighted that we are having this debate and to have the opportunity to put my views on the NHS in London on the record.
	I represent Islington, North, and most hon. Members who have contributed so far have mentioned the Whittington hospital in my constituency, as I will in a moment. However, the core of the debate is the question of the accountability of the NHS and how it operates. In London, the background is the Darzi report. Behind that, there are a series of associations-in my case, five north London boroughs have decided, as my right hon. Friend the Member for Holborn and St. Pancras (Frank Dobson) has pointed out, that they must cut £500 million from their budget in the next five years. I keep asking where that figure comes from, but nobody can tell me. They say, Well, it's a possibility, to which I ask, A possibility of what, from where, by whom? to which they reply, We have to think to the future.
	We all have to think to the future, but I do so in terms of improving health care throughout my constituency, north London and the rest of our capital city. I pay tribute to my right hon. Friend. When he was Health Secretary, he not only ensured large-scale investment in major hospital facilities, GP practices and all the rest of it, but put into operation the Black report, which was hidden by an earlier Conservative Government, and tackled health inequalities through health action zones and public health campaigns. There has been an improvement: life expectancy is greater; infant mortality and child obesity are lower; and a number of other things have improved.
	We have a long way to go, as everyone should be well aware. The population is increasing, and desperate inequalities still exist, as does very bad housing, so we need investment in health care across the piece. We do not need senior officials who lead shadowy existences to decide that in the long run, there must be a cut in health expenditure through our part of north London. My plea is on behalf of an awful lot of people who rely desperately on local health services and facilities, who do not have the alternative of private medicine-for them, it is the NHS or nothing, so we need the NHS to be the very best.
	Most speakers today, including my right hon. Friend, mentioned the future configuration of local A and E facilities across north London. As has been said, a proposal is lurking somewhere in the background of this debate. Eighty people-I do not know who they are-are being regularly consulted on the future configuration of health care across north London, and they appear to have decided that the most important hospitals are University College hospital and the North Middlesex, and that they will therefore downgrade or reduce everything else. I find that repugnant and wrong.
	When news of those proposals leaked out to us, I called two public meetings in my constituency. Three hundred people attended the first, and 350 the second, which does not include those who could not get in because the room was so full. We held a march and demonstration through Islington, and 5,000 people attended. They were not subject to scaremongering: they were there to show their support for their national health service, their local hospital and its A and E department. My hon. Friend the Member for Islington, South and Finsbury, my right hon. Friends the Members for Holborn and St. Pancras (Frank Dobson) and for Tottenham (Mr. Lammy) and the hon. Member for Hornsey and Wood Green (Lynne Featherstone) and I were all there, as was every political party from the Revolutionary Communist party to the Conservative party. Opinion was unanimous in support for that casualty unit. I know that the Minister has heard us and understands what we are saying about this.
	As a result of the march, I received a letter from the chief executive of NHS London, essentially telling me that I should not be so concerned. I read her letter with great care and was left even more concerned, because she talked about opening a hub at the Whittington hospital for north Islington, called a polysystem. I am not against GP-led health centres or improving primary care facilities. On the contrary, I am in favour of effective, efficient local GPs, but we should not close A and E departments. Casualty unit attendance figures in the north London area were 695,000 last year, of which 86,000 were at the Whittington. Do not close casualty units and do not cut our hospitals, and instead recognise that we conquer ill health and inequality by investment, not by cuts and closure. We conquer them by access, not by making services more complicated and less accessible.

John Randall: I welcome the opportunity to follow the hon. Member for Islington, North (Jeremy Corbyn). I, too, received an e-mail from a commissioner, which contained the worrying words:
	Targets and centralisation have driven morale to an all-time low, with money wasted and no flexibility to be innovative or unique.
	I go to regular meetings on this issue with my two colleagues from the other Hillingdon constituencies, and the terminology that we hear worries me. There is talk of turnover, margins and targets, which are of more use in the retail sector.
	A secret operation has been going on. The Minister said that it was clinician-led, but I have a copy of a letter sent by the deputy director of service transformation at NHS London to the sector chief executive of north-west London. I have not got time to read much from it, but some of it should strike terror into our hearts, because it shows that the proposals are not about clinical decisions. It states:
	Overall, there is a considerable amount of work to be done to produce a high-quality strategic plan for transforming services in NWL, one that captures priority actions to be taken, by whom and by when. You should work with your PCT chief executive colleagues to ensure the PCTs' contributions to delivering the strategy for NWL are clear and coherent and that their plans are properly aligned, where necessary, with yours. You are accountable for ensuring that the NWL Sector exhibits the right leadership to ensure that NWL's strategic plan is robust, to ensure the delivery of Healthcare for London at the pace that the changed economic context now demands. We are confident you have the right governance structure in place to make this happen.
	Those words mean, Make sure you get it right, like we've told you to do. These are the plans we want.
	The letter continues:
	Turning to your proposals for Local Hospitals and Elective Centres, there is no reference to the numbers you believe to be sustainable across the sector. I know that you have a programme in place for reviewing all hospital care settings and the plan should, at least, signal the likelihood that not all the current sites will make the transition to either MAH or Local Hospital.
	I could go on, but I do not have the time.
	The Government have undoubtedly put money into the NHS, but where has it gone? Like the hon. Member for North Norfolk (Norman Lamb), I think that it has gone into the new structures and bureaucracy and not necessarily where people expect it to be. The NHS has become like a huge sponge, with water being poured in, the money being poured out, and only drips coming down.
	I regret that the situation has arisen so near the election, because I do not want this to be a competition-it is not about that. I want to save my local hospital and services more than anybody else. The hon. Member for Islington, North talked about demonstrations and marches in his constituency and about the all-party support for them. In Hillingdon, there is nothing but unity among all the local Members of Parliament and the other parties there. This is about trying to preserve what we want for our constituents and fellow residents; it is not about trying to score party political points.
	In A and E departments, members of staff do not hang around waiting for work to come in; they are overstretched as it is. If, as is the suggestion in north-west London, three hospitals are left with an A and E department, Hillingdon will be saved. Of course, I would be delighted were that the case. However, if only two are to remain, I am afraid that Hillingdon will go, according to the plan. If Hillingdon is saved, however, Ealing is on the list to go-and where will all those people currently going to Ealing go? Are they all suddenly going to pour into Hillingdon hospital? There is not the capacity-never mind the difficulties of actually getting there and the geography of it!
	The matter must be put into the open. People should know exactly what is being proposed at an early stage.

Stephen Pound: As the hon. Gentleman has mentioned the great and glorious borough of Ealing, may I say that the 100,000 people who currently attend Ealing A and E department would, I am sure, have no objection to going to Hillingdon-we have nothing against Hillingdon? However, we would quite like to keep what we have got-thank you very much.

John Randall: The hon. Gentleman is absolutely right. We want Ealing to keep its hospital, because we do not want lots more cases coming to Hillingdon. The people of Ealing deserve to have their A and E department there.
	I know Hillingdon hospital. I was first a customer there in 1967, and my family and I have been using it since then. It is doing an excellent job. It has never had a particular golden age. In 1967, I had to wait a very long time to have my wrist reset, because there had been a major accident. However, David McVittie, at Hillingdon hospital, has been putting a lot of time and investment into ensuring that services are improving. We had hoped that a new hospital would be built-it was talked about-on the RAF Uxbridge site. That dream has disappeared. We hoped then that Hillingdon hospital itself would be improved-that was talked about, too-but that idea seems to have gone now. There is also talk about having one polyclinic in each area, but where they might be has only been talked about. What about the people who do not have to go to A and E? There is nowhere for them to go.
	We want the health centre in Yiewsley up and running. We have just opposed the move of a health centre from the green at West Drayton. I could go on about mental health services in London. While we are talking about our own hospitals, we should be talking about mental health services. Twenty one per cent. of NHS mental health beds in London have been lost over the past four years. My message to the NHS and the Minister is stop fiddling around with the systems and concentrate on delivering the service that my constituents and I, and all Members of the House and their constituents, expect and deserve.

Siobhain McDonagh: I want to tell a tale of two hospitals. Mitcham's Wilson hospital was endowed by a local benefactor, Sir Isaac Wilson, back in 1928. He specifically donated it for health purposes, but in the 1990s there was a Conservative Government. The public campaigned long and hard to keep this much loved cottage hospital open-but the Tories would not listen, and they closed it.
	Now, however, there is a different Government, and later this month the Wilson hospital will reopen as a general practitioner-led health centre, open from 8 in the morning till 8 at night-the hours that patients want-365 days a year. However, that is just the first stage of the plan to improve the Wilson, and it will ultimately be a full care centre offering diagnostics, a variety of medical treatments, dentists and GPs, out-patient treatments, physiotherapy, speech and language therapy, X-rays, electrocardiography, ultrasound, a baby clinic and even minor day surgery.
	What is more, the Wilson is not just getting a care centre; it is going to reopen as a proper cottage hospital, with minor operations and more than 50 intermediate care beds for people recuperating from operations or in need of care that they cannot get at home. The first stage-our local GP-led health centre-opens on 31 March. The remainder of the hospital will be open by 2013. That is still three years away and subject to planning approval, but I want to commend Ministers, officials and NHS staff for all that they have done so far, and take this opportunity to encourage them to keep up their good work. We are delighted with our new GP-led health centre, but we want the rest as soon as we can have it. The Wilson is in one of the most deprived wards in the whole of south-west London, and will make an enormous difference to many people's lives.
	That was the tale of the Wilson; now I want to tell the House about St. Helier hospital. St. Helier opened in the 1930s to serve one of Europe's largest council estates, but by the 1990s it had become shabby, and in 1996 it became infamous when patients were left on trolleys in the corridor because there were no beds. If anybody wants a reminder of what a Tory Government means, it is patients dying in the corridor because there is no room in the hospital. St. Helier was at rock bottom, so NHS bosses under the previous Government developed plans to shut it and move its services across south London to Croydon. Things happen slowly in the NHS, but a process was set in motion, and eventually the local NHS proposed moving everything to Belmont, in the Surrey suburbs. However, when residents across the region were consulted, Belmont was the least favourite choice. St. Helier was the favourite choice.
	Luckily, in 2004 there was a Labour council in Merton, and it called in the Belmont decision. A year later my right hon. Friend the Member for Leicester, West (Ms Hewitt) agreed with residents, instructing the NHS to rebuild St. Helier rather than relocate, because this would help reduce health inequalities. Unfortunately, as I am sure the Minister of State, my right hon. and learned Friend the Member for North Warwickshire (Mr. O'Brien), would admit, things do not always run smoothly in an organisation as big as the NHS. There have been a few jolts along the way, but last year London's NHS finally approved the full plans for St. Helier hospital, and last month the Department of Health gave them the green light.
	I would like to thank my right hon. and learned Friend personally for his enormous help. He has repeatedly met me, as well as the hon. Members for Sutton and Cheam (Mr. Burstow) and for Carshalton and Wallington (Tom Brake), who have been assiduously helpful themselves. He has been very hands-on, and has done his best to ensure that officials deliver the health service that people in Mitcham and Morden, Sutton and Carshalton all want. Now we just have to wait for the final rubber stamp from the Treasury. I thank Ministers for all their support.
	I have invited my right hon. and learned Friend to meet my constituents to hear what they think about our local NHS. I am pleased to say that he has agreed to join us later this month. He is very welcome. In many ways he is the personification of the tale of two hospitals, but it is also a tale of two Governments. The first was a broken Government running a broken NHS, shutting a cottage hospital that had been built to help poor workers in south London and plotting to close a general hospital where people were dying on trolleys because they could not find beds-the worst instincts of a Conservative Government.
	Those were the worst of times, but that was the 1990s. Now it is 2010. Our broken health service is slowly being put back together under a Labour Government, with the Wilson reopening and St. Helier not only safe from closure, but likely to be completely rebuilt. It might be stretching the point to say that we are now in the best of times, but things are certainly a lot better than they were. I am proud of the progress that we have already made and hopeful about future progress. On behalf of my constituents, I would thank like to thank everyone who has supported our local NHS in the past 13 years.

Lee Scott: I shall restrict my comments. I shall not be party political, nor shall I give a history lesson, because our constituents want and deserve more than cheap political point scoring, although it is unfortunate that this debate is happening at a time when a general election is to be held in a matter of a few weeks.
	Let me start by talking about secrecy. Normally, the hon. Member for Ilford, South (Mike Gapes) and I would be called in to the primary care trust for a meeting to discuss any proposals, but surprisingly on this occasion the trust did not want us together; it wanted us separately. However, when we went in, we both faced the same panel-a panel of doctors and clinicians-telling us why it was better for our constituents not to have services at King George hospital, and how that would benefit them. We were told that things would be absolutely fine, but let me say this to those bureaucrats. After a public meeting with hundreds of people, which I, like the hon. Member for Islington, North (Jeremy Corbyn), held, we too had a march involving all the parties. The hon. Member for Ilford, South and I, together with other hon. Members in the area, worked together for what is best for our constituents-not what is best for the political parties, but what is best for the people who put us here.

Jeremy Corbyn: Don't point your finger at me!

Lee Scott: I thank the hon. Gentleman for agreeing with me.
	The proposals to cut A and E, maternity and other services at King George hospital will benefit nobody-not one constituent in Ilford, South, not one in Ilford, North, and not one in Leyton and Wanstead, or Chingford and Woodford Green-because believe me, if the services at King George are cut, Queen's hospital in Romford will not be able to take the pressure.

Angela Watkinson: My hon. Friend is absolutely right. Before A and E, and maternity services, could be transferred from King George hospital, which would be a negative move for his constituents, additional space would have to be created at Queen's hospital, which is already at full capacity. That could be achieved only by moving some existing services elsewhere, but there is no suggestion of what those services might be or where they would be moved to.

Lee Scott: My hon. Friend is perfectly right. The biggest problem in this whole exercise is that Queen's hospital cannot cope even now. There are many occasions on which it cannot take A and E patients, who are diverted back to King George hospital, so how cutting the services there could possibly benefit anybody I do not know.
	We have also seen another major problem. We heard earlier about the NHS and rewards for failure. This House has heard me say before that the previous chief executive in the Barking, Havering and Redbridge trust got a substantial pay-off for working up one of the largest deficits in this country, totalling more than £100 million, which is why the current problems exist.
	The most important thing that can be said is that we have to protect the services. I promise that I am not scaremongering, but lives will be lost, given the time that it would take for someone living in the west of my constituency-for instance, in Hainault, where I happen to live, or in Woodford or Woodford Bridge-to get to Queen's hospital in Romford. The proposals have to be stopped. That is why, whatever motion we have tabled, if it says, We must halt this now, it is the right motion. We cannot have these ludicrous cuts. I have received more than 1,000 communications from my constituents. Surprisingly enough, not one has said, We think it'd be a good idea to cut services at King George-and that is true across the political spectrum; this has nothing to do with party politics or scaremongering. I have also received anonymous e-mails, but I am not even going to mention those because they were anonymous, and I do not know whether they were correct or not. However, I do know that many staff at the hospital are scared to speak their minds because they fear to lose their jobs. I understand and respect that.
	I have one final point. At the public meeting that I held, I was told by the PCT and a doctor that if somebody had a heart attack outside King George hospital, they would be taken to another A and E unit. I have never heard anything so ludicrous. How could it possibly be better for anybody not to be assessed at the A and E unit closest to where they live? If we do not stop the proposals-not only the proposals for King George hospital, but those for hospitals across our area-we will be letting down the very people who elected us to this House last time, and who will or will not elect us here in a few weeks. We are here to represent them. Let us not forget that.

Virendra Sharma: I welcome this opportunity to debate health care in London, primarily because there has been a lack of transparency and debate about alleged NHS London plans for my local hospital, Ealing hospital, and for other hospital trusts across London. Leaked reports from NHS London have caused great concern among my constituents about the future of Ealing hospital and its A and E, maternity, children's and acute services. The local paper, the  Ealing Gazette, has begun a campaign, along with the local community, to save our services at Ealing hospital, and I have pledged my support for that campaign.
	Since the NHS London report came to light, I have had meetings with Ealing hospital's chief executive, with representatives of Ealing PCT, and with consultants from the hospital. I have also had discussions and correspondence with NHS London and with the Secretary of State for Health. I should like to quote from the NHS integrated service plan for 2009 to 2014, which was drawn up by the north-west London commissioning partnership at the behest of NHS London. The following paragraph relates to the plans for Ealing hospital:
	The Sector is actively promoting and supporting the concept of the Integrated Care Organisation, bringing the PCT provider services of NHS Ealing and NHS Harrow together with Ealing Hospital Trust. All three Boards support this proposal. The provider services of NHS Brent are likely to join this organisation. This will promote an innovative locally based model of community provision. All involved acknowledge that this will, over time, reduce the level of acute services on the Ealing site and they will be transferred or tendered to other acute provider management to ensure their clinical and financial viability. This acute activity change will enhance the viability of the surrounding acute hospitals.
	I agree with Ealing's consultants that any reduction in the level of acute services at Ealing hospital will inevitably lead to the closure of the A and E department at Ealing, and the loss of acute services at Ealing can only mean that it will no longer be a meaningful local acute hospital.
	I agree with the British Medical Association's London regional council when it says that London's doctors and patients are being kept in the dark about NHS London's proposals. I also agree with its statement that
	Lord Darzi pledged that all changes would benefit patients, be locally led and that existing services will not be withdrawn until new and better services are available to patients so they can see the difference.

Stephen Pound: My hon. Friend is making a characteristically powerful case, and I know how much he cares for, and has fought for, the A and E department at Ealing hospital. Does he agree that of all the boroughs he has mentioned, Ealing has the largest population-nearly 330,000-and that those people have an extraordinary range of health problems and inequalities that are almost unique within the sector? Does he also agree that, if this glorious amalgamation-this great mélange of trusts-should come together, all that is special and unique about Ealing would be lost, including, above all, the ability of Ealing hospital to attend to those special needs and demands?

Virendra Sharma: I thank my hon. Friend for that intervention. I agree with him, but I shall not repeat what has already been said by other hon. Members about this.
	I recognise the need to develop more locally based primary care services at polyclinics, but they are as yet unbuilt and untried. Ealing hospital has approximately 100,000 A and E patients each year and, although many of those could be treated in a primary care setting, many could not, and those patients are dependent for their treatment-and, in some instances, their lives-on the acute services that are an integral part of the A and E department. With such large numbers visiting Ealing's A and E, which was originally designed to treat only 30,000 patients, we have to ask ourselves where they would all go if the A and E were to close.
	I am still deeply concerned about the future of Ealing hospital. I live only five minutes away from it, and I am not planning on moving away from the area, so it will always be my local hospital. My children and grandchildren also see it as their local hospital. My grandchildren were born there, and my daughter-in-law received life-saving treatment there. Ealing hospital serves the majority of my constituents, many of whom are from ethnic minority groups and who do not have English as their first language. They are often disadvantaged, vulnerable and voiceless. They would have to travel much further if A and E and acute services were closed or downgraded at Ealing hospital. Their distinctive cultural and language needs are currently well met by the hospital, and I doubt that that would be the case elsewhere. Along with the consultants, I am also concerned for the safety of patients if there were no A and E and acute services at the heart of my community at Ealing hospital.
	I am committed to speaking up for my constituents on this issue, and I have tabled an early-day motion that I ask other concerned Members to sign. I have also written to Mr. Speaker requesting an Adjournment debate on the same subject. I hope that these alleged plans never see the light of day, but if they are real, they must be brought out into the open so that local people can find out what is being proposed and make their views known. I for one want to make it very clear that I oppose any plans, real or otherwise, to downgrade acute services at Ealing hospital. I am grateful to you, Mr. Deputy Speaker, for allowing me to speak in this debate and to put this on the record.

Susan Kramer: I particularly appreciate this opportunity to speak in the debate in defence of my local hospital, Kingston hospital. I am joined in my campaign by my hon. Friend the Member for Kingston and Surbiton (Mr. Davey). We first learned of the risk to the hospital's accident and emergency and maternity departments towards the end of last year. We told NHS officials that we thought the plans were outrageous. Kingston's maternity department deals with nearly 6,000 births a year, and the A and E unit treats more than 100,000 patients a year. It is therefore busier than almost any other hospital that has been mentioned. We agreed that we would hold back from going public with our campaign until the documents had been published. However, we were told in January that the documents would be withheld until after the general election, so we went public with our campaign anyway.
	I have heard about cross-party campaigns in every corner of London, but I am incredibly sad to say that south-west London is the exception, and accusations of scaremongering have been levelled against my hon. Friend and me today. Those who did so are well aware, however, that, on 8 February, we put into the public arena the document that was leaked to us confirming everything that we had said about the threats to Kingston hospital. That document-the South-West London Strategic Plan: private and confidential: final draft-is now on our website. It lists the 18 options under consideration, nearly all of which, unfortunately, involve the loss of services at Kingston hospital.
	Those hon. Members will also be entirely aware that, on 24 February, Kingston's health overview panel held a five-hour scrutiny meeting, at which NHS representatives were questioned for almost the entire time. I will read the local newspaper's report of that meeting. It said:
	NHS bosses have bowed to public and media pressure and confirmed the closure of Kingston Hospital's accident and emergency and maternity units is being considered as part of a review of services in the area.
	That is from our very reliable  Richmond and Twickenham Times. We have also put into the public arena today, through our website, the presentation to NHS Kingston's joint board and professional executive committee meeting, dated 15 January. That document unfortunately shows the situation to be even worse, involving a greater loss of elective surgery than we had feared. I am expecting a sincere-and, I hope, written-apology from those on the other Benches.
	More than anything, however, I am here to ask for the disclosure of information. My local residents want to be part of this conversation in detail. They want to understand all the facts and issues now, when they can be part of the fundamental discussion, and not when they have been told that they can find out about them. At that point, three final options will be presented to them, and there will be a 12-week formal consultation, which can have an impact only at the edges.
	We have put freedom of information requests in place, but the response to all of them was, You are asking for too much information. But there is no such thing as too much information for the public, who need to be able to participate and make decisions. Although I intend to pursue those FOIs, let me show how bad things are by reading from the front of the leaked document, now on the website:
	The document contains extensive material that is exempt from disclosure under the Freedom of Information Act 2000. It should not be released under the Act without prior consultation with the NHS in South West London.
	Even FOIs will not obtain the full range of information.
	I am incredibly sad to say that the Conservatives do not join us in the wish for full information. The hon. Member for Hemel Hempstead (Mike Penning) declared in the debate of 8 February that he would not have put into the arena the information that we have, which I find shocking. On 24 February, after five hours of questioning the NHS, Liberal Democrat councillors at Kingston council moved a resolution. It said that since the panel was now aware of the first of the documents, the south-west London strategic plan, it called
	upon NHS London to publish this document immediately.
	Every Conservative councillor present voted against that resolution. I am afraid that we are in a battle for information by ourselves.
	The House will be interested to know that my Conservative opponent joined in a letter with my Labour opponent and the Green, all saying that our campaign had been invented and amounted to scaremongering. I envy the many others who have cross-party co-operation because that is what people in our area deserve and should have. I turn to the Government and ask them to provide the information so that our local people can be fully engaged and involved in absolutely key and critical decisions at a time when decisions should be flexible and are formulated. I also turn to the Conservatives and ask why they are singling out south-west London as place for which they do not demand information and why they will not join in the defence of the hospital, because it is time that they did, for the sake of all our constituents.

Emily Thornberry: Let me begin by putting the issues in the context of Islington. We have clearly benefited hugely, with the tripled budget, from the Labour Government's investment in the health service. We have the best cancer unit in Britain in the world's oldest hospital, at Barts. We have new doctor surgeries and more money is spent on health per head in Islington than anywhere else.
	We also have the fantastic University College London hospital. My family, I am afraid, know the hospital all too well. The last time I went to its A and E department, my 10-year-old shouted rather loudly, Mummy, this is normally where we sit. The A and E was built for 60,000 people to go to, but now 100,000 people go there. I understand that the A and E at the Whittington hospital has had £32 million invested in it. The reason we have all this money spent in Islington is because we die too early. Although the death rate has declined over the last few years, it is still very marked indeed, as about 46 per cent. of Islington residents die prematurely.
	We have done well, but we now hear that the NHS in Islington has, after a dance of seven veils, a plan to close the Whittington A and E and the maternity unit, to which we say, But why? We are told that it is because we are going to be £560 million short, to which we say, Well, why? Where did you get that from? What are you talking about? Frankly, we get very little response that makes any sense. We then say, Is this because you are anticipating a Tory Government? Because do you know what? There hasn't even been an election yet. Who knows whether or not we are going to have to suffer a Conservative Government? Why are you making plans in anticipation of those sorts of cuts?
	There has been, and still is, a great campaign. It was launched in Islington and is led by local MPs. As my right hon. Friend the Member for Tottenham (Mr. Lammy) said at a large meeting after a demonstration, saving the Whittington is one of the few things that unites Tottenham and Arsenal supporters. We have a great campaign, which has involved more than 10,000 people, half of whom were on the demonstration that marched up Holloway road last week. We have had packed public meetings, led by my hon. Friend the Member for Islington, North (Jeremy Corbyn). The  Islington Tribune has provided crucial support to the campaign, as has the  Islington Gazette.
	Let me assure the Islington PCT that we mean business; we do not expect the A and E or the maternity unit in the Whittington hospital to close. If decisions are to be made locally, the PCT should listen to local people. If it wants a consultation, all it has to do is ask, and we will tell it to leave the Whittington alone. If it thinks otherwise, it will have a fight on its hands.

David Burrowes: I am pleased to follow the hon. Member for Islington, South and Finsbury (Emily Thornberry). We are part of the north central London sector, facing similar challenges from the 80 or so wise men and women who are determining the health care of the people in our areas.
	We often say that our constituencies are unique and require special attention, and no more so than my constituency and Enfield more widely. Perhaps, however, that should not the case in this instance, as we are all concerned about secrecy and plans that are being meted out without proper public consultation or clinical input. In Enfield, we can peer into and go beyond the world of Darzi and see what the real world could be like. We are, in a sense, the leaders of the pack when it comes to health care for London. Plans were put in place three years ago, which in many ways have been mirrored across London, so let us peer in and see what has happened in Enfield.
	A consultation took place. We hear a lot in documents about wide consultation, but it did not reach the doors of many of my constituents or, indeed, those of my hon. Friends the Members for Chipping Barnet (Mrs. Villiers) and for Broxbourne (Mr. Walker). The consultation was woeful and incomplete, leading to widespread concern and a lack of confidence. It gave a clue as to what the world would look like if the Darzi model were followed through, and people should be concerned. It is apparent that the call for a local-led solution was nowhere near the mark when it came to Enfield. This was a top-down model, prescribed from on high and greatly restricted in the options presented. It asked the questions to produce the answers that were wanted in order to justify the Secretary of State's decision in September 2008 to downgrade consultant-led A and E and maternity services.
	Interestingly, if one had gone across the country at the time of the consultation, one would have seen a replica model of health care being followed through. The model had nothing to do with any particular input or variation in local need. There were similar campaigns on the Sussex coast-across Chichester and Worthing, for example. All the models were based on the same one that came from on high in Enfield.
	The same has been said elsewhere. Sir George Alberti came in as the troubleshooter to fix the problem. He also recognised the lack of public engagement and expressed concerns about the need for clinical engagement. Crucially, he said there was a need for pump-priming and bridge funding for the PCTs to ensure that their primary care services were in place before any of the secondary care changes were made.
	Was there a bright new dawn in Enfield, which others could welcome and then follow down the same road? In the cold light of day in 2010, we see a primary care trust that is still strapped for cash and facing a historic debt of some £25 million. It is still struggling to get within a double-digit figure for its current debt, while the area still struggles to get any decent primary care. The poly-systems are hardly in place across the borough and we are left with the Secretary of State's decision to downgrade consultant-led A and E and maternity services. We have had some clarity about the situation, so we know that we are left with a 12-hour urgent care centre and at best a 24-hour doctor-led primary care service at Chase Farm hospital.
	As in Islington and elsewhere, we had a march, with thousands of people participating, and I was joined by my hon. Friends the Member for Broxbourne and for Chipping Barnet and by the hon. Member for Edmonton (Mr. Love) and the right hon. Member for Enfield, North (Joan Ryan). We were all together, campaigning to ensure that we retained our consultant-led A and E and maternity services. Thousands of people signed petitions; the Conservative parliamentary candidate for Enfield, North, Nick de Bois, led the campaign, presented the petition and worked extremely hard.
	What has happened to the campaign now? We have lost it. There has been a division. Conservative Members are full square behind the need to recognise that there should be consultant-led care, but the champagne has been popped, regrettably, by the right hon. Lady at the door of the A and E unit. What was the celebration? A downgrade of our services. It is not possible to sit on both sides of the barricades in this argument; it is necessary to stand full square behind the people of Enfield, who do not want a downgrade of our services.
	What is the situation 18 months after the consultation? There is increasing demand, with more than 3,300 births at Chase Farm hospital and more than 100,000 attendances in A and E. My constituents-all our constituents-are asking why, given all the money that is going into the health service and given the rising demand, we are reducing access to accident and emergency services while increasing management of contracts and increasing waste. They want a new financial model and a new clinical model that would ensure that we look at the position again.

Charles Walker: Why does my hon. Friend feel that the concerns of people in Broxbourne and Enfield have been ignored throughout the process?

David Burrowes: I think that in many ways the deal was done before the point of engagement was even reached. As other Conservative Members have pointed out, the decision had already been made. Models have been adopted, irrespective of the different clinical needs.
	Eighteen months on, we are seeing not just a campaign on Chase Farm, but a prospect that is even worse, whether that is at the Whittington or elsewhere. The £500 million funding gap is raised, and there is the question of whether between one and three major acute hospitals-the North Middlesex or Barnet, for example-will retain a 24-hour A and E service. A document published by NHS London questions whether it would be safe for those local hospitals to retain their maternity units, despite the increasing birth rate and increasing demand.
	The proposals are unacceptable, and it is clear that we should halt them, not for the purpose of political convenience but because of the need for proper financial and clinical models. The choice is clear: people can support Labour if they want the status quo-a continued hospital downgrade-or they can support the Conservatives if they want the security of change that is based on local and clinical need.

Tony McNulty: The hon. Member for Enfield, Southgate (Mr. Burrowes) was doing so well until the end of his speech. This debate has to be slightly bigger than the ponderous party politics outlined by him then, and outlined earlier by the hon. Member for South Cambridgeshire (Mr. Lansley). The notion that there is a land of milk and honey just waiting for the time when the hon. Member for South Cambridgeshire takes over is palpable nonsense, and the hon. Gentleman knows it.
	A point made by the hon. Member for South Cambridgeshire went to the core of the matter. There is a dilemma between the local and the strategic in London, which has been woefully neglected since the inception of the national health service. I would say-of course I would, as a suburban Member of Parliament-that for too long everything has been sucked into the centre, courtesy of the fancy and precious London teaching hospitals, which admittedly are wonderful, and to the detriment of the suburbs. That dilemma has still not been resolved, and sadly it has not been and will not be resolved by Boris Johnson, as the hon. Member for South Cambridgeshire intimated.
	On health as on a bunch of other things over the past two years, Johnson has done nothing of any consequence for public health or health in London. I stood here, or roughly here, in 1998, during the passage of the Bill that became the Greater London Authority Act 1999, and said that if in 10 years' time the Greater London assembly and the Mayor had not evolved enough to take a significant and direct role in the strategic health concerns of London, the Act would prove to be a failure. For all the glossy little documents that Boris Johnson has produced, he has, as I have said, done nothing of any consequence.
	If we are honest in a cross-party context, we must agree that the dilemma is between the strategic and the local. I take the point made by the hon. Member for Enfield, Southgate, who lamented what had happened to Chase Farm. Chase Farm matters to me as well, because it is linked with Barnet, and if Barnet health authority decides to do things at either Chase Farm or Barnet there will be consequences for Edgware hospital, which is 10 yards away on the other side of the Edgware road.
	Where does the local begin and where does it end? In January 1997 the Tories closed Edgware general hospital. They downgraded it, and left it with Barnet. It cannot be enough to make the local prevail over the strategic when people's health needs do not recognise borough boundaries in a nice convenient way.

Theresa Villiers: A few months ago the Secretary of State signed off the controversial downgrade of Chase Farm that was mentioned by my hon. Friend the Member for Enfield, Southgate (Mr. Burrowes), on the understanding, and on the basis of repeated promises, that Barnet would be upgraded to take the pressure and the extra patients. How can the right hon. Gentleman possibly justify the decision of NHS London to discuss downgrading Barnet after the promises made about Chase Farm?

Tony McNulty: The hon. Lady should listen. I am not justifying it at all. I am simply saying that what happens in one part of London has serious ramifications in another part of London that is apparently not particularly close to it.
	The key question is If not this, then what? Does there need to be a strategy review and overhaul of what is going on in London? I think that everyone would answer Yes, but anyone who answers No is living in the past, because the real world moves on. However, when it comes to the question of whether the bureaucracy has the capacity and is properly equipped to deal with such an overhaul, I hesitate. Let me give an example. When the maternity service at Northwick Park hospital was reconfigured 10 or 12 years ago, it could not have been known that more than half the cases presenting to the service would be in the high-risk category, because that particular part of the population was not there then.
	Where are the flexibility and responsiveness that would make it possible to deal with the dynamics of what is going on in London? Local needs cannot just mean PCTs. Unlike the hon. Member for Orpington (Mr. Horam), who has represented about three dozen parties and four constituencies-he is not in Chamber at present-I do not argue that there should be far fewer PCTs. There should be co-operation between PCTs. I believe-and here again I agree with the hon. Member for South Cambridgeshire-that there are local dimensions in which public and preventive health should be provided all the more.
	Over the past 20 or 30 years, a collective failure of public policy has meant that preventive medicine and primary care have not developed as they should have. Anyone who visits any other European country will find that most of the cases that present to A and E encounter nothing resembling the provision here, because people in such countries as Germany and Sweden are much more aware and much more educated.
	If various different organisations such as trusts and PCTs are to deal with local health provision in this country, my one plea is that they should talk to each other. Apart from the Royal National Orthopaedic hospital, whose trust is separate from the PCT, there are no hospitals in my constituency. Edgware community hospital, 10 yards away on the other side of the Edgware road, is hugely important, but is run by Barnet. Just the other side of the Northwick Park roundabout is Northwick Park hospital, in the constituency of my hon. Friend the Member for Brent, North (Barry Gardiner), which is run by Brent. In the middle is Harrow PCT. At present the PCT is doing some very good work looking into the possibility of a polyclinic and the reconfiguration of GP services in the east of the borough, which is long overdue. Barnet, meanwhile, is considering what provision for Edgware community hospital should be over the next 10 years. Are they talking to each other? Not enough.
	It is true that Northwick Park, to which my hon. Friend the Member for Brent, North will no doubt refer, has been given stroke status-if that is the right phrase-and is developing its acute facilities, while also dealing with serious financial consequences; but is it talking to Barnet about what will be provided at Edgware? Is it talking to Harrow PCT about the configuration of GPs in the east of Harrow? Can the three together come up with a solution that has a degree of synergy? That is almost sub-strategic, but it is certainly supra-local.
	Simply talking about things being driven by local needs is bunkum. Simply talking-as I know Ministers are not-about things being driven top-down is equal bunkum. Where are the mechanisms that could get things right in the middle? I fear that they have not yet been developed. I think that the concern about sector-based and sometimes secretive solutions is partly due to the fact that no one in one part knows what those in the other part are doing. Of course there should be more openness, but there must also be a strategic review that takes local dimensions fully into account.

Andrew Pelling: I am very mindful that others wish to speak, so I shall be brief. The Minister constantly refers to the way in which these are local initiatives, but it has been clear in the debates from the four quarters of London that a single blueprint is being pursued on these proposals. I have a great deal of admiration for the hon. Members for Kingston and Surbiton (Mr. Davey) and for Richmond Park (Susan Kramer) because of how they have ensured that this debate has the highest profile. However, I fear that we will pass round the black spot as it were, on this proposal because if they are successful in defending services at Kingston hospital, somewhere else in the sector will lose out. I have been impressed, in a way, with how NHS officials have spoken to me in dramatic terms, saying that I will kill or disable people if I oppose these proposals. However, I beg to differ, particularly as regards the impact on Croydon.
	Croydon Members must remember that Croydon is a very ethnically diverse community and that more than 13 per cent. of our constituents are over 65, which is a higher proportion than the London average. We must remember that Croydon has a large black and minority ethnic community, which faces particular health issues to do with diabetes and stroke. Reference has been made to the concentration of stroke resources at St. George's hospital, which we campaigned against in Croydon. With this proposal we again face the prospect of the removal of a great deal of specialisms from hospitals such as Mayday university hospital. This sort of downgrading, which is also proposed for St. Helier and Kingston hospitals, means that that they will become local hospitals. In essence, this proposal will turn Mayday university hospital into what the Croydon general was: it will become, in effect, a place for respite and recovery. When I said that this is a bit like having a university where the research professors have been sent 10 miles down the road, I was told that I need not worry because the consultants would visit one day a week. That was not a terribly reassuring briefing to receive on how these things will work.
	Obviously one must be cautious about what one discusses in terms of the secret documents that we were allowed to see. The document given to me and to the Liberal Democrat Members in south-west London shows clearly a proposal whereby
	58 per cent. of A and E activity
	would be moved from hospitals in south-west London. That, along with the ambition to move more than 60 per cent. of current hospital out-patient appointments and the other drawing of patients away from GP surgeries into polyclinics, is disturbing.
	I wish to conclude by giving an example of how difficult it will be to deliver on some of the savings that are in this secret document. We are talking about savings of about 33 per cent. I am concerned that an incoming Government, desperate to deliver financial savings in a Budget proposed within 50 days, might reach for this document and say, Yes, we can deliver. That delivery will not happen, and I shall give hon. Members the Croydon example to show why.
	Croydon has two polyclinics, one of which is to be found in the constituency of the hon. Member for Croydon, South (Richard Ottaway). He has been vehement in expressing his concern about the redevelopment of Purley hospital, which was promised in 2001. He raised the issue again and received reassurances from the Conservative Front-Bench team about it today. It has taken eight or nine years to get nowhere on that hospital, and that is an example of how polyclinic savings will not be delivered, because the place has just not been built yet. As for my constituency, people will have to go to a polyclinic in the centre of Croydon, sited on a slip road off a flyover. Let us try to imagine people having to go there in an emergency. They are not going to go on a bus. It will not be easy to deliver a baby on a slip road off a flyover. If there is a prospect of people being able to park, they will be competing in a town centre with residents who are already desperately competing for parking spaces. These are practical examples of how NHS officials-people who are making the decisions, and not democratically-have no understanding or sense of the real practicality of delivery.
	The final point I wish to make-I apologise to hon. Members for taking my allocated six minutes-is that this decision should be made during the general election campaign; it should not be postponed in the way that the Conservative motion surprisingly suggested or in the way in which the Labour Government and NHS officials wish. This decision should be made during a general election-when patients have real influence on the debate and on the decisions that will be made-rather than their being made by faceless NHS officials.

Barry Gardiner: In international women's week, I wish to pay tribute to all the women who work in our health service, from chief executives and chairs of trusts, to nurses, porters, physiotherapists, catering staff, cleaning staff, consultants, doctors, midwives and, above all, health visitors. The overwhelming majority of health visitors are women, because that is a profession that, above all, requires common sense. How many times throughout the world have women turned to their families after some apparent crisis and said, At least we've got our health?
	Our physical and mental health is the bedrock of all that we do and all that we are. As an MP, I therefore take a fundamental interest in and fundamental responsibility for the quality of health care services that my constituents enjoy. My interest must be not just in outputs-how much money or resources the Government make available-but in outcomes such as mortality rates, quality of care and speed of treatment. I must also bear responsibility, not for individual cases but for the configuration of services, their proper resourcing and the proper benchmarking and monitoring of delivery.
	Northwick Park hospital and St. Mark's hospital fall inside my constituency and, together with Central Middlesex hospital, which lies in the constituency of my neighbour, my hon. Friend the Member for Brent, South (Ms Butler), form the North West London Hospitals NHS Trust, which serves most people in Brent and Harrow. I am proud to say that it is the only trust assessed as excellent for the quality of its services in outer north-west London. Last summer, I was delighted that the trust was designated as one of only eight hyper acute stroke units for London. We have all seen the excellent public services adverts about FAST-Face, Arms, Speech, Time. I congratulate the trust on its success in winning this key unit, which is part of a scheme projected to save 500 lives a year across London. Although I was delighted by the announcement, may I advise the Secretary of State that I will be even more delighted when the Northwick Park hospital's trust is announced as one of the major acute hospitals for the sector, thus upgrading it still further? I trust that such an announcement may come later this year.
	While discussing major acute trusts, I must comment on the intervention by the hon. Member for Hammersmith and Fulham (Mr. Hands), who is no longer in his place. He suggested that five accident and emergency departments would close at the eight north-west London hospitals. The Healthcare for London report actually talked of creating three major acute trusts. He has interpreted that to mean that three hospitals would stay the same and five would lose their accident and emergency departments, whereas in fact the strategic health authority has confirmed that all five will keep their existing accident and emergency departments, but three are due to be upgraded into what will, in effect, be super-providers. I trust that Opposition Members will now stop portraying as a cut what is in fact a proposed upgrade.
	There are three key milestones for the Northwick Park hospital's trust. The first is dealing with the hospital's historic debt of £21.5 million. That will take place over the next two months when the primary care trusts across London meet to agree their support for wiping out that debt. The second is the public consultation on the future configuration of the sector this autumn. The third is the support from NHS London to embark on a hospital rebuild.

Andrew Lansley: Just so that the hon. Gentleman does not misrepresent what is in the north-west London sector document, I should say that page 54 makes it clear that the local hospitals-those that are not designated as major acute hospitals-will include a
	GP led Urgent Care service.
	Contrary to what is said in the NHS London document, the north-west London document does not promise local hospitals a continuing emergency department.

Barry Gardiner: I do not know whether the hon. Gentleman has had the benefit of speaking both to the chief executives of the hospitals and to Ruth Carnall from the strategic health authority. He would find that she has confirmed that there are no plans to take away the accident and emergency departments from those hospitals.
	I turn now to my local primary care trust, NHS Brent. Four years ago, I was extremely critical of Brent PCT and was in part responsible for initiating the turnaround plan. Today, NHS Brent is one of the two fastest improving PCTs in the country based on the Care Quality Commission performance ratings for 2008-09. It is a borough that recalls 19-hour waits on trolleys in A and E under the Conservatives, and it is meeting its targets on four-hour waiting lists. In particular, it has exceeded the 93 per cent. target for cancer waits of no longer than 14 days. Critically, this is about not only improved targets, but lives saved: mortality-not only for cancer but for cardiovascular disease- has vastly improved.
	All mortality has improved from 87 per 100,000 only two years ago to 79 per 100,000 now. Health inequality lies at the heart of this debate, and in the south of Brent, in Stonebridge ward, the average life expectancy is almost 10 years less than that in some of the more affluent wards that I represent in Brent, North.

Stephen Pound: On that point, my elder brother was born two years before the national health service and he died as a child. The next brother died. I was born in the same week as the national health service and I am still here. However, the key point is surely that there is confusion in the national health service. Doctors and clinicians feel that they are not being given the space to breathe and to do what they do best. Does my hon. Friend agree that there seems to be a disconnect between the public affection, respect and need for the national health service and this strategic exercise that is not being connected up at the moment?

Mr. Deputy Speaker: Order. Before the hon. Member for Brent, North (Barry Gardiner) continues-and I ask him to keep an eye on the time-may I say to the hon. Lady and hon. Gentleman below the Gangway that they should not be reading newspapers in the Chamber?

Barry Gardiner: My hon. Friend the Member for Ealing, North (Stephen Pound) made his point in a characteristically robust fashion.
	I want to focus on health inequality, and it is clear that one of the best ways of addressing health inequality is through increasing physical activity, particularly in the young. I urge the Department of Health to invest far more than it has in the past. It has already begun to work in this area and the Change4Life campaign that the Department has been running is extremely productive in this respect. I believe that much more must be done in co-operation with the fitness industry and with sports providers throughout the capital to ensure that we not only address the problems of obesity in the young but set up a platform for fitness throughout life that will help to address health inequalities as a whole.

Clive Efford: On a point of order, Mr. Deputy Speaker. In response to the rebuke that you just gave to me, I want to tell you that I was reading something that had just been pointed out to me. The  Evening Standard seems to have a report on today's debate that is in the past tense in a newspaper that was printed before the debate took place.

Mr. Deputy Speaker: I merely say to the hon. Gentleman that it is a convention of the House that Members do not read books or newspapers while a debate is taking place. There are other places- [ Interruption. ] Order. There are other places in which that can be done.

Justine Greening: I am sure that many people watching the debate will think that that time could have been better spent focused on what Members from all parties were saying. Indeed, as we have heard over the past few hours, concern has been expressed from both sides of the House about the process that is unfolding and about how our NHS services in London will be reconfigured over the coming months unless we halt this process. I hope that tonight's debate has given Ministers some cause for concern, because residents across London are absolutely furious that they are not being involved in this process in the way that they want to be.
	We all know that London is a diverse and vibrant city. Residents are very mobile. Migration and demographic patterns mean that we have an every-changing population. That is a key part of London's identity, but we know that when it comes to providing health care in the capital, it means that we face some unique challenges. Even the Minister of State, Department of Health, the right hon. and learned Member for North Warwickshire (Mr. O'Brien), when he was introducing the debate on behalf of the Government, admitted that Londoners put up with a worse health service than other parts of the country, in spite of the tireless work of NHS staff in our primary care trusts, GP surgeries and hospitals.
	I hope that at the end of this debate Ministers will address some of the concerns that have been raised. Although in London we have some of the best hospitals in the country-and, indeed, even in the world-we also have, as we have heard, some of the worst health outcomes, with stroke, heart disease and cancer being particular causes of concern.
	Health inequalities in London are complex. The London poverty profile shows that three quarters of the London boroughs with the highest rates of premature death are in inner London. The risk of premature death in Newham and Lambeth is 250 per 100,000 people, which is twice that in Kensington and Chelsea. There are also unequal levels of long-term illness, with east London disproportionately affected. The last census revealed that 15 per cent. of adults in Islington, Hackney, Newham and Barking and Dagenham suffered a long-standing illness-twice the level of such illness in Richmond and Kingston. It is perhaps no wonder that some of the Members representing those constituencies have taken the opportunity to flag up their concerns about the changes in health care provision that could be coming down the track for their constituents.
	What have we had in response to that complex series of health care needs? We have a city-wide strategy from NHS London and now, as we have heard today, some specific plans are being worked up, apparently behind closed doors, by individual so-called NHS sectors. NHS London has predicted that its funding shortfall by 2017 could be £5 billion. On the back of that assessment have come some serious unfolding plans to reorganise services, shifting care away from acute hospital provision to community services and centralisation of specialist services.
	Those far-reaching changes have raised the prospect that behind closed doors we could have plans for some of London's hospitals to be downgraded and even closed down. In all the proposals that seem to be being worked up, it is interesting to see that there does not seem to be much mention of the fact that management costs in the NHS have skyrocketed. There does not seem to be much mention of the fact that 15 per cent. of the estates owned by the NHS in London are either unoccupied or underutilised. I know that from personal experience, as the Putney hospital site in my constituency has been derelict for the past decade. The local primary care trust apparently has no ability to bring it into use for our local health care provision.

Edward Davey: I am grateful to the hon. Lady for giving way and I agree with an awful lot that she is saying. Will she say a little more about the Conservative motion, however? She calls for the reconfiguration to be postponed
	until a more effective public consultation is in place.
	How would her public consultation differ from that proposed by the Government, which is due to start in some sectors of London around the autumn?

Justine Greening: I think it would have a number of important differences. First, it would be led at a local level by GPs. The Minister has said that clinicians are discussing it among themselves, but we think that that is not good enough. Of course clinicians need to be involved, but so do GPs and, critically-this has come across in every speech made tonight-so do the public. People feel like they are going to be presented with a fait accompli when they have had no opportunity for input at an early stage. That is why we have had the debate today-to start a proper debate that the public can be part of. If Ministers ignore that, they will be going down a very dangerous route.
	Serious questions have been raised today about the reliability of the funding projections on which the reorganisation is based. The assumptions are questionable -they have even been questioned by the work of the King's Fund, for example, which seems to undermine whether the assumptions we have will actually work. Above all, it seems to be a financially driven process. We need a careful, considered assessment of London's health care needs and of how they will change over the coming years.
	In particular, we have heard concerns about the fact that we will see patients transferred to community services when those services, or polysystems, as they are being called-more impenetrable language that the public can never understand-are not even necessarily in place. That is a real concern. We heard the concerns expressed by my hon. Friend the Member for Enfield, Southgate (Mr. Burrowes) about what has happened in his constituency, which flag up that we are right to be concerned.
	I shall make progress, because I know that the Minister will want to answer some of the concerns that have been raised tonight. Of course, the other issue that has emerged is, as has just been mentioned by the hon. Member for Kingston and Surbiton (Mr. Davey), that the approach has been secretive. We have all urged our local NHS providers to be transparent with the public about the process. Whatever the Minister says, it is not being driven locally-it does not even seem to be driven clinically. The public seem to have no access to the debate that is going on in the inner recesses of the NHS, and they are deeply concerned about that. We need a different approach that is rooted in local communities and that involves GPs, clinicians and, critically, the public.
	The conclusion to the debate must be that the current process has been discredited and should therefore be halted. The assumptions regarding the solutions that have been worked up about moving services into the community are flawed financially, the focus is apparently on cutting front-line services rather than on challenging the massive growth of bureaucracy in the NHS that has occurred under Labour, and the public have no involvement in the process at the very time when they should be central to it. That simply is not good enough. As we have heard, there is simply no transparency. I take this opportunity to urge NHS London to start being transparent and to start communicating with the public on the ground in the communities who are so worried about what is going on. Instead, the Minister has tried to justify the process when he should be challenging it. There has almost been unanimity across the Chamber regarding our concerns about this process. I conclude by saying that we all have a chance tonight to represent those concerns on behalf of our constituents. If we do not take that chance, I am sure that our constituents will represent their own concerns about this issue at the ballot box.

Ann Keen: First, let me say what a pleasure it is to be part of the debate with the hon. Member for Putney (Justine Greening) this evening. The case for change in London is undeniable. When Lord Darzi started the process of reviewing the NHS in the capital, London was consistently rated as the worst of the 10 strategic health authorities. Its rates were among the worst for mortality, waiting times, quality measures and patient experience. It is impossible to argue that that was an acceptable state of affairs.
	Much has been said about inequality in health tonight, particularly by the Conservative party. That is pleasing because I believe that until Labour came into government in 1997, the words inequality in health were not allowed to be uttered in the Department of Health. Londoners deserve, at the very least, the same chances and the same level of care and treatment that their family and friends in other parts of the country receive. That is what Healthcare for London is about.
	The massive task of turning health care in London around is not led by politicians in Westminster, the Government or civil servants in Whitehall. It is all run by clinicians-doctors, nurses and other dedicated health care professionals on the ground-in close consultation with the communities they serve. The Healthcare for London framework for action was developed in response to that, and the case for change and the recommendations for responding to it were accepted by the public. Primary care trusts consulted on the case for change and received more than 5,000 responses. We had about 40,000 visitors in all to the website and to meetings and roadshows. The public were clearly in favour of our making a set of changes built on considerations of quality, safety, outcomes and patient experience. A joint London overview and scrutiny committee that represented all 33 boroughs was formed, and it agreed the proposals with recourse to the Secretary of State referral. That gives the proposals local legitimacy and means that we can be held to account for their delivery.

Clive Efford: I am grateful to my hon. Friend for setting out how the consultation took place. She, like me, will have worn out her shoes campaigning against many Tory cuts in the NHS. It is worth reminding the House that in the period between 1979 and 1997, 10 hospitals were closed in Greenwich. In comparison, a brand new community hospital is being opened in the heart of my constituency in 2011.

Ann Keen: That has also to do with the calibre of the MP and what they can bring to an area. Certainly, when I worked in the health service under the Conservative party, Barney Hayhoe, who is now a Lord, was a Health Minister, but one thing that he could not have been accused of was selfishly looking after his own constituency's health needs. I spent most of my time working in a crumbling old workhouse.
	All the decisions that have been, are and will be made must be based on hard evidence and what works in the best interests of the patient. The objective of all the changes is simple-to save thousands of lives.

Andrew Slaughter: After five years, my constituents are fed up with Tory smears that my local hospital will be closed or downgraded or that it will lose vital services. In fact, it is expanding and improving under Imperial College Healthcare NHS Trust. At the risk of trying my hon. Friend's patience, I ask her to confirm again that there are no plans to close the A and E at Charing Cross, Hammersmith or St. Mary's hospitals.

Ann Keen: I can give that assurance to my hon. Friend. There is no case for that at all.

Mike Gapes: My hon. Friend will know that I tabled an amendment, which was not selected, asking the Secretary of State to refer to independent review the proposal for reconfiguration in outer north-east London. Will she arrange an urgent meeting between me and her ministerial colleagues to discuss that proposal, which is supported by my local authority, the London borough of Redbridge and by the hon. Member for Ilford, North (Mr. Scott)?

Ann Keen: I assure my hon. Friend that that meeting can be arranged and that that consultation with us can, of course, take place.

Andrew Dismore: The Minister of State, Department of Health, made it pretty clear earlier that Whittington A and E department is safe. Will my hon. Friend make the same pledge regarding the Royal Free?

Ann Keen: All the proposals are being considered clinically and in the appropriate way. [Hon. Members: Ah!] Opposition Members must not read anything into that. Their scaremongering is at its height in tonight's debate, but we will not take any more scaremongering this evening.
	Many of the polyclinics that have been set up, including the Heart of Hounslow clinic in my constituency and another in Hammersmith and Fulham, are making a huge difference to what takes place in A and E departments. London's A and E departments are used and sometimes abused differently than those in the rest of the country. The way forward is to bring primary care into polyclinics- [ Interruption. ]

Mr. Deputy Speaker: Order. The debate is in danger of disintegrating. The Minister is replying to a debate in which a great many hon. Members have taken part. They are entitled to hear her reply, and I should like the debate to be finished in good order, as there is another debate to follow in which a great many hon. Members seek to take part.

Ann Keen: Thank you, Mr. Deputy Speaker. We must always consider the evidence, and the evidence shows that patients will receive better outcomes when they are treated in specific hospitals that have a high volume of particular clinical work. The changes are about patients being seen by the right people in the right place with the right equipment at the right time. Some difficult and sensitive issues have been touched on in the debate, and we are sensitive to the views of colleagues and their constituents on these matters-particularly to the wisdom that has been shown by my right hon. Friend the Member for Holborn and St. Pancras (Frank Dobson) regarding the way in which all such consultations should be conducted-because the outcome is about safer patient care.
	We must remain focused on the fundamental aims of the changes, which are to improve health care in London. The changes will save thousands of lives, will improve health outcomes in relation to major diseases such as cancer, heart disease and stroke, and will improve the overall quality of other health services to reduce disability and prevent pressure from being placed on our acute hospitals. Change is necessary to improve services, and we cannot and must not back away from the problems. Ministers have made it clear tonight that any changes in London must follow an agreed set of principles.

Virendra Sharma: Given the needs of the unique and diverse communities in the area around Ealing hospital, can the Minister assure me that the hospital's A and E department will not be closed?

Ann Keen: There are no proposals to close the A and E department at Ealing.
	Change must always be to the benefit of patients. It must improve the quality of care that patients receive, in terms of clinical outcomes, experience and safety. Change must be clinically driven. We will ensure that it is to the benefit of patients by making sure that it is always led by clinicians, and based on the best available clinical evidence.
	All change must be locally led. Meeting the challenge of being a universal service means that the NHS must meet the different needs of everyone. However, universal is not the same as uniform: different places have different and changing needs, and local needs are best met by local solutions.
	I believe that MPs and Ministers are right to protest in their local areas if they feel the need to. As to marches, we on this side of the House are very good at marching, because we have had years of experience of marching to save our NHS. A local decision will involve the local MP, and he or she may be a Minister.
	The local NHS will involve patients, carers, the public and other key partners. Those affected by proposed changes will have the chance to have their say and offer their contribution. NHS organisations will work openly and collaboratively. We are clear that any changes have to meet those requirements. If they do not, the powers exist to refer them to the independent reconfiguration panel.
	Yes, we need to change to save lives. If we are honest, however, Governments for too long have backed away from the tough decisions needed to tackle these issues. I worked-

Andrew Robathan: claimed to move the closure (Standing Order No. 36).
	 Question put forthwith, That the Question be now put.
	 Question agreed to.

Question put ac cordingly (Standing Order No. 31 (2)), That the original words stand part of the Question.
	 The House divided: Ayes 214, Noes 284.

Question accordingly negatived.
	 Question put forthwith (Standing Order No. 31(2)) , That the proposed words be there added.
	 Question agreed to.
	 The Deputy Speaker declared the man Question, as amended, to be agreed to (Standing Order No. 31(2)).
	 Resolved,
	That this House recognises that there are health inequalities, particularly around heart disease, stroke and cancer, to be addressed in London; agrees that there is a need to build stronger organisations which are clinically and financially sustainable and provide the best service to their local populations; recognises the importance of the work by Lord Darzi and over 200 clinicians who undertook the Healthcare for London review, which was widely supported and consulted on in London; recognises that trusts have worked closely with their local communities to communicate the aims of the programme; further recognises that lives will be saved because the NHS in London, supported by public consultation and following review and scrutiny by local and pan-London Health Overview and Scrutiny Committees, has agreed to implement new stroke and trauma networks surrounding world-leading major trauma centres and hyper-acute stroke units to ensure that patients receive high quality and innovative care in centres of excellence, expected to save approximately 500 lives a year; acknowledges that there have already been improvements in cardiac outcomes; notes that there must be no further changes to accident and emergency or obstetrics departments unless and until improved access to new services is available and that any changes must be subject to full and formal public consultation; and further notes that the Government is preparing robust planning systems to ensure that NHS London is fully prepared to meet the challenges posed by the London 2012 Olympic Games.

Local Government (Devon, Norfolk and Suffolk)

Mr. Deputy Speaker: I advise the House that Mr. Speaker has selected the amendment in the name of the Prime Minister, and also that an eight-minute limit on Back-Bench speeches will apply to this debate.

Bob Neill: I beg to move,
	That this House expresses grave concern at the manner in which unitary restructuring is being imposed on local government in Devon and Norfolk; questions the legality, motivation and financial probity of restructuring in Devon and Norfolk during this pre-election period; notes that the Permanent Secretary has had to seek a Ministerial Direction from the Secretary of State as to the value for money and feasibility of restructuring at this time; further notes that the Permanent Secretary has concerns regarding the legal vulnerability of current restructuring plans in the case of judicial review; cautions that distinguished academic research fundamentally undermines the economic case for unitary restructuring; asserts that restructuring will place an additional cost burden on council tax payers in Devon and Norfolk; regrets the ongoing uncertainty created in Suffolk over the restructuring plans; commends much wider joint working and shared service arrangements between local authorities as important ways of delivering efficiency savings; believes it is an abuse of the democratic process; and calls for the draft Statutory Instruments pertaining to restructuring to be subject to a debate on the floor of the House and then for the proposals to be withdrawn.
	This is not the first time that we have raised the issue of Norfolk and Suffolk local government restructuring in the House, and we make no apology for doing so yet again. It is all the more important that we take this opportunity to raise the issue on the Floor of the House because, for reasons that I hope we will be able to set out fairly succinctly, there is an extraordinary set of circumstances, which gives rise to a couple of the most bizarre statutory instruments we have ever seen.

Hugo Swire: Shameless.

Bob Neill: Indeed. It is extraordinary behaviour, and we can set out why. We make no bones about tabling a motion condemning in trenchant terms the attitude and behaviour of the Government towards restructuring in Norfolk and Devon.
	It is worth reviewing a little of the background to the present situation. Hon. Members will recall that back in 2007 the then Secretary of State invited a number of local authorities to make bids for unitary status. The key point is that about 26 bids were received. It was made clear by the then Secretary of State that they were to be judged against five strict criteria, which have been the basis upon which all subsequent decisions have been taken. It was made clear that to be successful, bids would be expected to meet all five criteria. Particularly relevant to this case were the criteria of affordability and value for money.
	It is perfectly reasonable to take differing views about the virtues or otherwise of unitary local government. There are unitary local authorities across the country. Some of them work well and are successful. There are two-tier areas of local government across the country-three tiers, the parish councils would want to say-in county and shire districts, and they often work well too. That is not necessarily the driving consideration, although I will come to a point where there are real grounds for concern about the methodology that the Government have adopted, through the Department for Communities and Local Government, in assessing some of the supposed benefits of the recent tranche of reorganisations, but that is not necessarily the principal consideration here.
	The principal consideration is the Government's extraordinary behaviour in departing from their own tests and well trailed standards to produce two unitary proposals that they had unequivocally rejected out of hand as unacceptable and unable to meet two of their own criteria. The intellectual-and, some might be tempted to say, political-dishonesty is the principal issue that gives rise to this debate.

Bob Russell: The hon. Gentleman is making an exceptionally good case against the Government, but so that I can better understand the view of Her Majesty's official Opposition, will he tell me whether he is in favour of unitary authorities in principle, or against them?

Bob Neill: The hon. Gentleman knows perfectly well that we have said that we should not impose unitary local restructuring. Imposition is the real issue, because unitary authorities of all political complexions can work. That is not the point here: the point is the imposition, and the imposition by unreliable and, frankly, perverted criteria.

Hugo Swire: Does my hon. Friend think it a complete coincidence that the only two Members who are satisfied with the situation are both members of the Labour party?

Bob Neill: I was going to address that point in a moment, but it seems appropriate to do so now, because I observed a very strange thing. I was trying to work out what had happened since 2007, when the same Government -albeit with a certain change of personnel-rejected those two unitary bids on the ground that Norwich and Exeter were not capable of meeting two of the three criteria.
	I am conscious of something other than the change of personnel, however. The Labour party has lost one third of its seats in those two cities. It has lost a parliamentary seat, and a certain injustice has been shown in this world, because I have not yet mentioned that there was also a proposal for Suffolk. It was thought that there should be reorganisation in Suffolk, too, but that has been shelved. The people of Suffolk are not to be treated to a partial unitary reorganisation in which an area is ripped out of the rest of the county-rather like bleeding chunks of Wagner, as Ernest Newman once described it-and separated off.
	They are not going to have it, Instead, they are to be treated to an entirely new beast: a county constitutional convention. Nothing quite so grand as a national constitutional convention, mark you, but a new, municipal constitutional concept. All that demonstrates, however, is that, first, the Government have exceedingly inconsistent standards, and, secondly, there is rough justice in this Government. My hon. Friend was right to refer to the two most satisfied people, because if one is or was in the Cabinet, one gets a unitary authority, but if one is a mere Under-Secretary, all one gets is a talking shop.

Charles Clarke: My intervention follows the hon. Gentleman's answer to the hon. Member for Colchester (Bob Russell). The hon. Member for Bromley and Chislehurst (Robert Neill) stated that the Conservative Opposition, if they were in government, would never impose unitary government. Did I understand that right? Is he saying that if the Conservatives were in government and any district council opposed unitary status, there would never be unitary status? Would there never be any new unitary authorities if the Conservatives were in government?

Bob Neill: We have made it quite clear that we oppose imposed unitary local government, and I restate that. We oppose it because, first, it is a very significant distraction, and, secondly, the benefits of joint working, shared services and more effective service delivery are being achieved in two-tier areas through collaboration between district councils. I shall develop that point later. It just so happens that the three counties under consideration all have advanced and effective means of shared service working, which the Government choose to disregard and rip up. I have been pretty clear about our position.

David Drew: Shared service delivery may well be working in those counties, but it certainly is not in Gloucestershire. What should Gloucestershire Members do? Many, from across the parties, would move towards a unitary authority.

Mr. Deputy Speaker: Order. We ought to stick to Devon, Norfolk and Suffolk.

Bob Neill: I am very happy to follow your strictures, Mr. Deputy Speaker.
	I shall review what has happened since the proposals were made. The intention was that the strict criteria should be adhered to, and it was made quite clear that they had not been met. Since then, however, there has been a lengthy and protracted consultation, a number of judicial reviews, the Secretary of State sought advice from the boundary committee for England, which came up with some proposals that were clearly not palatable, and more consultation has taken place. Finally, the Minister for Regional Economic Development and Co-ordination, the right hon. Member for Doncaster, Central (Ms Winterton), who will open for the Government in this debate, said that she and the Secretary of State would move swiftly to come to a decision and resolve uncertainty. All I can say is that the decision has not resolved uncertainty in Suffolk, although it may at least have resolved uncertainty for two parliamentary candidates elsewhere in the country.

Norman Lamb: Does the hon. Gentleman share my horror at the extraordinary amount of public money that has been committed to the process, which has resulted in the evidence being ignored? All the money that both sides have spent on lobbying and lawyers ought to have been spent on services for vulnerable people, particularly at a time when public services are under enormous strain.

Bob Neill: I could not agree more. It is a fairly regrettable and bizarre state of affairs, and that brings me conveniently to the latest twist and turn of events.
	Having said that they intended to find certainty, the Secretary of State in relation to Norfolk and the Minister of State in relation to Devon-the Secretary of State fairly set out why he should not be involved in that matter-came, amazingly, to the same conclusion. They did not go ahead with the county-wide unitary structures that had, rightly or wrongly, been the preferred view of the boundary committee for England; they did not maintain the status quo, which had been ruled out but might have been an option; and they did not look at any other option. Instead, they decided to revert, suddenly and without any warning, to the two small city unitary proposals that had been ruled out before, leaving the remaining counties on a two-tier basis. It was a wholly new approach that had not been canvassed or significantly consulted on. That behaviour, coupled with, as the hon. Gentleman rightly says, the expenditure of public money, triggered another fairly unprecedented development.

Ronnie Campbell: rose-

Bob Neill: Before I come to that development, I shall let the hon. Gentleman come in.

Ronnie Campbell: I do not want to start off on bad terms, but I must say that Northumberland went through the same procedure, and we are in a right shambles-a right mess: we are supposed to be saving £80 million, and cutting £30 million. We had a referendum, and 53 per cent. of the people in Northumberland said that they did not want a single unitary authority, but the Government imposed it. So the hon. Gentleman is going down a dark alley here, because they are going to impose it on him whether he likes it or not. That is what they did with us.

Bob Neill: There are occasions when I find myself in agreement with the hon. Gentleman, and he speaks from experience about Northumberland.
	I shall return to the finances, but I want to deal with the latest developments, because the Secretary of State and the Minister, having decided on that wholly new departure, provoked a letter from the permanent secretary at the Department for Communities and Local Government, in his capacity as accounting officer. He felt constrained to write to the Secretary of State, in effect seeking a direction, saying in terms that because of his concerns he required a direction from the Ministers in order to implement the proposals.
	It is worth saying why the permanent secretary felt obliged to do that-the background being that the Secretary of State and the Minister of State had to concede, as was apparent to anyone who looked at the evidence, that the proposals still did not meet the five criteria. Nothing had changed in that regard, but they had a new idea that there were now compelling grounds to permit departure from the criteria. I am glad that at the fag end of a Government there is still some inventiveness left in Ministers; it is a pity that all it involves is their trying to punch their way round the rules. In any event, they invented the new concept of the two compelling criteria.
	The permanent secretary had this to say:
	Whilst I understand these wider reasons, I am concerned that the approach you are currently proposing makes it difficult for me to meet the standards expected of me as Accounting Officer.
	My main concern about your proposed course has to be value for money for the public purse. It would impact adversely on the financial position of the public sector as compared with the alternative courses of action open to you.
	In reference to the costings in the Secretary of State's proposed version, he says:
	I recognise that if your proposed approach of a unitary Norwich and Exeter achieves the economic gains you envisage-
	That was one of the compelling reasons why it was thought that economic development would be better advantaged by these small city unitaries, though I note in parenthesis that the evidence submitted to the Merits of Statutory Instruments Committee in the other place points out most compellingly that all the development areas and opportunities for the two cities are in fact outside the boundaries of the new unitaries. None the less, it was thought that having small unitaries would be better.
	The letter continues:
	there may be off-setting benefits to the public purse from increased jobs of extra local and national tax revenues and reduced benefit payments. The evidence for such gains is mixed and representations that you have received provide no evidence to quantify such benefits. I also recognise your proposed approach may open the way for improved public services through the Total Place approach-
	that was the second compelling reason-
	but this will be dependent on the collaboration of all the councils concerned and as yet there is no clear evidence of the costs and benefits that may arise.

Ian Austin: rose-

Bob Neill: I am happy to give way to the hon. Gentleman; perhaps he is going to tell me what the costs and benefits are.

Ian Austin: Is it not the case that, as a former Prime Minister once said, advisers advise but Ministers decide? Is the hon. Gentleman saying that if he is ever a Government Minister he will do only what he is told by his officials, and never take a decision for himself?

Bob Neill: No, but I do expect a rational Minister to have a sound base of evidence for the decision that they come to.

Hugo Swire: rose-

Angela Browning: rose-

Bob Neill: Against that background of seeking a rational and sound evidence base, I will read out another paragraph and then give way to my hon. Friends.
	The accounting officer goes on to say:
	Moreover, any departure from the criteria when taking your statutory decisions also raises feasibility, as well as value for money, concerns.
	Feasibility is one of the grounds on which an accounting officer can, and properly should, raise the issue of a direction from his Minister. He continues:
	Whilst there is no statutory basis for the criteria-
	although everyone worked on that assumption-
	there is a legitimate expectation that they will be the basis of your decisions. Your proposed approach of implementing a unitary Exeter and Norwich, and not implementing a unitary council for Suffolk would be a departure from the criteria, and whilst I recognise you could adduce your reasons for this as public policy grounds for not meeting the legitimate expectation, my clear legal advice is that the risk of decisions for a unitary Exeter and Norwich, and indeed for not taking action on Suffolk, being successfully challenged in judicial review proceedings is very high. You have been advised that there is every likelihood of such judicial review proceedings being commenced-
	and they have been.
	The letter goes on:
	This poses significant risks for the feasibility of successfully delivering your currently intended approach. The probable nugatory expenditure which this would entail, particularly in the case of Exeter and Norwich, could only exacerbate the worries I have described about value for money. And it would also put pressure on departmental resources, altering priorities.
	I have deliberately read out that long passage in full, because it is utterly condemnatory of the Government's behaviour and makes a most potent case against it.

Angela Browning: The idea that we have Ministers serving who, having been in office for so long, do not understand the responsibilities and role of an accounting officer in a Department is really quite dreadful.

Bob Neill: One would have thought that some of the Ministers concerned had been in office for long enough to have got around to reading the Ladybird book of what a Minister does, but apparently not, so far.

Hugo Swire: Are we not beginning to see a theme in this? The Under-Secretary of State just described the permanent secretary as an adviser, and the Secretary of State for Culture, Media and Sport, the right hon. Member for Exeter (Mr. Bradshaw), in a bizarre outburst, said:
	The selective leaking of internal correspondence has confirmed the suspicions long held in Exeter (and Norwich) that London-based civil servants have consistently been biased against Exeter and Norwich and have been firmly in the county camp.
	That suggestion was completely withdrawn by the Under-Secretary of State for Communities and Local Government, the hon. Member for Stevenage (Barbara Follett), who said:
	All I can reiterate is that officials and Ministers in the Department for Communities and Local Government behaved entirely properly and the letter was not leaked.-[ Official Report, 2 March 2010; Vol. 506, c. 228WH.]
	Are we not seeing a complete breakdown between Government and the civil service at this point?

Bob Neill: My hon. Friend is absolutely right. It is a most depressing and worrying precedent when a senior Cabinet Minister apparently makes an attack on the permanent secretary of another Minister's Department-a mere adviser, who is actually, of course, the accounting officer and acting perfectly properly.

Henry Bellingham: rose-

Bob Neill: Before I give way, I will make one other point, which highlights the constitutional concerns that are raised by the behaviour of the right hon. Member for Exeter in his blog-I understand that it is called Ben's Brain Bubbles-in making that assertion, which the Under-Secretary absolutely and categorically refuted. All I can say is that Ben's brain bubble will have been well and truly burst by the end of today.

Henry Bellingham: Will my hon. Friend tell the House how many requests for directions from accounting officers to Secretaries of State there have been since the war, because this is obviously quite a dramatic development?

Bob Neill: My hon. Friend has asked a question to which I do not readily have the answer. However, I am told that there have only been about nine in the whole length of time that this Government have been in office since 1997, and this is the first such direction that has been asked for by the Department for Communities and Local Government or its predecessor bodies, so it is an almost unprecedented circumstance.

Richard Bacon: The permanent secretary is not merely an adviser in this respect-as accounting officer, he is exercising his legal responsibility to Parliament to account for public money.

Hugo Swire: His duty.

Richard Bacon: It is his legal responsibility and, as my hon. Friend says, his duty to account for public money. We are familiar with the fact that Ministers in this Government are used to engaging in nugatory expenditure, but does not the fact that the Minister does not understand this indicate very clearly that their time is up?

Bob Neill: I could not agree more about the lack of understanding. The concerns that exist about the financial basis on which Ministers have made their case in relation to this, and in relation to other unitary reorganisations, have been reinforced by Professors Chisholm and Leach in their book, Botched Business, which had already pretty comprehensively demolished the financial model that was used for previous unitary reorganisations, as alluded to by the hon. Member for Blyth Valley (Mr. Campbell). Writing recently in Public Money and Management magazine, Professor Chisholm points out that a careful analysis of the transition costs self-assessed by the new unitary authorities shows that they are £47 million out from the transition costs asserted by the Department. In all cases, they have turned out, with one or two exceptions, to be significantly higher, so the methodology adopted by the Department is demonstrated, by significant academic research, to be significantly flawed.

Adrian Sanders: The hon. Gentleman makes the point that there have been many developments. Is he up to date with the latest one today, the letter from the Minister for Regional Economic Development and Co-ordination to the leaders of the councils affected? It states that
	a unitary Exeter will be able to tailor public services to the needs of its urban area 'while still being able to achieve economies of scale that are possible under the countywide delivery of such services as adult social care and children's services'-
	the very two services that Exeter will get from being a unitary authority. What nonsense!

Bob Neill: I was pretty amazed when I realised that the Minister had taken time out from her doubtless busy schedule to write that letter, at the very moment when I had assumed she would be carefully crafting her eloquent, reasoned, closely argued and evidence-based response to the debate. Instead, she decided to write to the local authorities in the two counties concerned urging them to do what, ironically, they are already doing. She extols the virtue of joint working, and she and I are at one on that. The irony is that the two counties, and indeed Suffolk, which remains in some kind of municipal limbo, are all local authorities with excellent records in joint working. I shall take this opportunity to give some examples.
	Norfolk has an excellent and detailed shared services agreement and its LEAPP programme-lead, engage, aspire, perform in partnership. In Devon there is the integrated Devon concept and a series of joint local strategic partnerships, joint chief executives and joint service provision-all the things that the right hon. Lady is urging them to do, they are already doing without any need to be told by her. There is a joint growth point between Exeter and East Devon councils, which is important for these purposes because of all the growth outside Exeter. In Suffolk there is a pathfinder scheme for joint working.
	Those are not local authorities that require a lecture from the right hon. Lady about joint working. The letter says something about the Government's priorities, and indeed about their timing and public relations, but I do not suppose we should expect otherwise. It demonstrates that the Government have made, in the words of one response from Norfolk that I have seen, a perverse decision. In the words of the Saffron Housing Trust-not a particularly political body, I suspect-it was the least rational choice.

Andrew Smith: Do not the hon. Gentleman's dismissive remarks show that he has a complete absence of understanding of the pride that such historic cities take in themselves and their wish to rule themselves? Oxford is the same.

Bob Neill: Actually, I have a great deal of respect for the pride that those cities have. They have their lord mayors, and I have been pleased to see some of the civic work that they do, as do the historic counties. A sensible balancing act has to be carried out. Pride is an important consideration, but so must be proper process and consistency with the Government's own criteria. With every respect, I do not remember pride being one of the five criteria. Perhaps when the Minister opens the Government's defence, she will tell me that that is a third compelling reason that she has managed to think of in between writing letters to local authorities up and down the country this afternoon.

Phyllis Starkey: The hon. Gentleman talked about joint working and seemed to suggest that if councils had joint working arrangements, they should logically merge and cease to be separate councils. Is that the purport of what he is saying? Is he saying that every council that is in a partnership with another one should merge?

Bob Neill: No, I was not saying that, and I am surprised that the hon. Lady could possibly interpret my comments that way. She is highly experienced in local government matters, and as Chairman of the Select Committee on Communities and Local Government I honestly think she can do herself more credit, with respect. That is clearly not what I am saying-indeed, I was saying the reverse.
	The twists and turns have not quite finished yet. The statutory instrument for the unitary authorities was of course laid in the Commons, but it was also laid in the Lords, and the other place has a Select Committee on the Merits of Statutory Instruments. Generally it does not make any particular report on them, but for only the third time that I recall, in this case the Merits Committee drew the special attention of the other place to the statutory instrument because of its concerns about it. The summary of the report of about 170 pages that the Committee produced states:
	The Department has proposed the creation of two unitary councils...which do not conform with all of the Department's five published criteria. In these circumstances we would have expected the DCLG to have set out a more detailed case for the proposed course of action than the assertion of 'compelling reasons' with little supporting evidence. The parts of the explanatory material to which this Committee routinely looks for evidence to support a policy proposal, in particular the Impact Assessment and the outcome of consultation, do not in our view combine to make a clear, evidence-backed case for the proposal.
	The Merits Committee asked the Department to produce some evidence, but stated:
	The Department's response...has failed to provide more robust evidence.
	It therefore concluded:
	These Orders are drawn to the special attention of the House-
	the other place-
	on the grounds that they give rise to issues of public policy likely to be of interest to the House and that they may imperfectly achieve their policy objective.
	Given the rather guarded language that is used in the other place, in our robust words down here we might say that the Merits Committee was saying that the process stinks. It is a departure from the norm and there is no evidence for it. Ministers were asked to provide more evidence, but what the Merits Committee got was simply a recycling of what had already been stated, in which contradictions abound.
	It was made clear at the beginning that a proposal that did not meet the five criteria would not proceed. As their Lordships' Merits Committee pointed out, the proposal being adopted is contrary to previous practice. The Committee said that it would be helpful if the DLCG would
	give a much more explicit analysis.
	Instead, it found:
	The DCLG response...simply repeats the wording of the written statement. It does not estimate any projected cost savings or efficiency gains.
	That sums it up-it was a blunt, almost insolent response to a serious piece of work by the Merits Committee of the other House.

Linda Gilroy: Does the hon. Gentleman accept that there is very strong cross-party support for unitary status in Exeter? What have his Exeter colleagues said to him about the merits of that particular case?

Bob Neill: I do not accept that contention, taken across the county, at all. The other place's Merits Committee rightly concluded that the Government were adjusting their standards because it was unclear what they regarded cross-party support as referring to. It asked whether it referred to the cities or the counties.

Richard Younger-Ross: rose-

Hugo Swire: rose-

Bob Neill: I apologise to my hon. Friend; I will have to make some more progress. The hon. Member for Teignbridge (Richard Younger-Ross) has not come in yet, so I give way to him.

Richard Younger-Ross: I thank the hon. Gentleman, who has been very generous in giving way.
	Is not the problem that the whole process was deeply flawed from the very beginning? The Boundary Commission was hog-tied before it could start, because the whole county, including the cities of Plymouth and Torquay, could not be taken into account in considering a rational basis for a unitary authority. It was confined to a very limited remit.

Bob Neill: That is perfectly true, and having set up a questionable set of rules to start with, the Government are now trying to change those rules to get themselves off the hook.
	It was interesting to see what some of the respected local government press had to say about this issue. The  Municipal Journal had a headline along the lines of Reorganisation descends into a Whitehall farce, which is about right. A respected columnist in the  Local Government Chronicle, Mark Smulian, not unreasonably invoked the ghost of Governor Elbridge Gerry, the man who gave rise to the gerrymander. I regret to say that that is ultimately what we are talking about here-a sordid little gerrymander, carried out by Ministers to advance a narrow and sectional interest. They are flying against evidence and seeking to distort it when it does not suit them. When the rules get in their way, they seek unilaterally to change them. The Secretary of State has ignored all objective criteria and pushed ahead for one reason only: the sectional interests of the Labour party are put first. That is why the permanent secretary took the unusual step of requiring a direction, and why we are now seeing a Government in a desperate situation pursuing the politics of division, and pitting town against country.
	We raise this issue without any apology, and I am making it abundantly clear that we will press the matter to a Division, so that all hon. Members can stand up to be counted. The decision is not just thoroughly bad-we might disagree when a decision is 50:50 or 60:40-but utterly against the weight of all evidence. It is bad for the inhabitants of the counties and cities involved, and bad because it creates a very serious constitutional precedent indeed. For that decision to be taken in the dying days of this Parliament is close indeed to as grave an abuse of office by Ministers as I have seen in many a long day. I am sorry to have to say this, because I have always regarded the Ministers involved as decent and reasonable people even though I disagree with them, but in my judgment, the authors of that decision should be utterly ashamed of it.

Rosie Winterton: I beg to move an amendment, to leave out from House to the end of the Question and add:
	recognises the benefits that will accrue to the people of Exeter and Norwich, and to the surrounding areas of Devon and Norfolk, from a unitary authority in Exeter and a unitary authority in Norwich; believes that after more than three years of public debate on these issues it is now right for Parliament to consider and finally resolve them; looks forward to debating the draft structural change Orders in the very near future; notes the benefit to local people, including the substantial efficiency savings being achieved, of unitary councils established on 1 April 2009; recognises the wide support for unitary local government in Suffolk; and calls on the councils and right honourable and honourable Members for that county to work quickly together to reach a consensus on a unitary solution for that area..
	The amendment sets out why my right hon. Friend the Secretary of State and I are very clear that the decisions we have taken are in the best interests of the people of all the areas concerned: the people of Norfolk, including the people of Norwich; the people of Devon, including the people of Exeter; and the people of Suffolk.
	Before I comment in more detail on the Opposition motion, let me remind the House of the history of the process that led to those decisions. The Government issued a White Paper, Strong and Prosperous Communities, and an invitation to councils in England in October 2006, well over three years ago. These explained that local government in two-tier areas can face additional challenges and risks, duplication, confusion and inefficiency in the provision of services to the public. We therefore invited councils to come forward with proposals for unitary local government if they felt it was right for their area.
	In January 2007, we received proposals from Exeter and Norwich city councils for unitary city councils. Following careful assessment by the Department, in July 2007, the then Secretary of State, my right hon. Friend the Member for Salford (Hazel Blears), said that she was minded to implement the Exeter proposal and to refer the Norwich proposal to the independent boundary committee for advice. She asked for more information from Exeter council on the financial case.
	Following further consideration, in December 2007, my right hon. Friend announced that we would be seeking the committee's advice on the proposals for both Exeter and Norwich and made a formal request for advice in February 2008.

Nick Harvey: If the then Secretary of State was previously minded to proceed with Exeter's bid, but then sought financial information before deciding instead to refer the matter the boundary committee-at the point the Minister just described-why did the Secretary of State change her mind? What financial information did she receive?

Rosie Winterton: In January 2007, my right hon. Friend said that she was minded to implement the proposal, but asked for more information. On the basis of that further consideration, she said she would seek the advice of the independent boundary committee on the proposals for both Exeter and Norwich, and made a formal request in February 2008.
	The committee was due to submit its advice by 31 December 2008, but it was unable to do so owing to a judicial review. The deadline for the receipt of that advice was therefore extended three times until the committee finally submitted it in December 2009. I therefore say to right hon. and hon. Members that the process was in fact anything but rushed. Some would say that it has gone on for far too long. Indeed, many Members who came to see me thought that, and my right hon. Friend the current Secretary of State has consistently made clear his intention to bring the process to as swift a conclusion as possible to minimise uncertainty in the areas concerned.

Keith Simpson: I want to refer back to Norwich. Norwich had its application for unitary status turned down on its current boundaries because it could not meet the criteria laid down by the Department. Three years on, the Minister has overruled the boundary committee and we have gone back to the proposal of a unitary Norwich on its current boundaries. Surely that is completely and utterly contradictory.

Rosie Winterton: I will come to the reasons why, having looked at all the proposals before us, we took the decisions we did. The hon. Gentleman came to see me. He was opposed to all forms of unitary local government in Norfolk. The logic of his argument is that if we looked totally on cost grounds, Norfolk would revert to unitary local government. I do not understand where that argument is going, or what the Opposition are proposing.
	I shall now remind the House how the Government took the matter forward once we received the boundary committee's advice. First, we allowed a six-week period for representations to be made. The Secretary of State and I then had before us seven unitary proposals. We had the boundary committee's recommended proposal for a single county unitary council for Norfolk, and Norwich city council's original proposal for a unitary Norwich; the boundary committee's recommended proposal for a single county unitary council for Devon, and Exeter city council's original proposal for a unitary Exeter; and the boundary committee's recommended proposals for a single county unitary for Suffolk, a proposal for a split two-county unitary, and Ipswich borough council's original proposal for a unitary Ipswich.

Hugo Swire: There was another suggestion, and I wonder what happened to it. Perhaps I do not know solely because it was ruled out, but the suggestion was for an Exeter unitary combined with Exmouth in my constituency.

Rosie Winterton: That proposal did not come forward through the boundary committee process.
	Central to our decisions was an assessment of each proposal against the five criteria: affordability; broad cross-section of support; strategic leadership; neighbourhood empowerment; and value for money services. Those criteria specified outcomes that should be delivered if the proposed changes to unitary structures were to be made and if the unitary proposals were to be implemented. Accordingly, our assessments against the criteria involved making prospective judgments as to the likelihood of future outcomes being delivered. Our assessment-contrary to the committee's views-was that the alternative proposals for single county unitaries in Devon and Norfolk did not meet all the criteria. Having considered the original proposals for Exeter and Norwich afresh against the criteria, our assessment was the same as that of my right hon. Friend the then Secretary of State in December 2007-namely, that they too did not meet all the criteria. Having made this assessment, we considered the merits of each proposal, giving careful consideration to the circumstances in which there were compelling reasons to depart from the presumption that proposals that meet all the criteria are implemented and those that do not are not implemented.

Richard Bacon: I do not understand why, in the case that the Minister is talking about, she appears not to be concerned that the proposals departed from the criteria, when the decision that the Government have taken now also departs from the criteria for reasons that, far from being compelling, appear to be utterly spurious.

Rosie Winterton: I am just coming to an explanation of that. We looked at the wider consideration of the merits of each proposal. The suggestion that this is somehow a new or novel procedure is not true. In December 2007, when the then Secretary of State took her statutory decisions, she approached them in the same way. She recognised that it was in principle open to her to conclude-on the basis of the information available to her-that all the criteria were not met, but there was none the less a good reason to implement the proposal, or conversely that all the criteria were met, but the proposal should not be implemented. In the event, she decided that, having regard to all the circumstances then prevailing, it was appropriate at that time to implement the nine proposals that met the criteria and not to implement those proposals that did not meet the criteria. This conclusion was made clear in the statement by the then Minister for Local Government on 5 December 2007, in which he expressly explained that the basis for those decisions was the Secretary of State's assessment of the proposals against the five criteria set out in the original invitation, which had the status of guidance under the 2007 Act, and to which councils should have had regard when making their proposals.
	This approach to decision making was reflected in the Department's letters of 29 June and 7 December 2009 to councils in the affected areas. These letters made it clear that an assessment against the criteria, while central to our decision making, would not be the sole determinant as to whether a proposal was implemented. In contrast to the unitary proposals that we considered in 2007, we judged that the circumstances today for Exeter and Norwich are very different, as I shall explain. We concluded, when looking at the merits of the proposals in the round, that there were reasons-which we found compelling-why the unitary proposals should, despite not meeting all five criteria, be implemented, given the circumstances.
	In the case of Norwich, that was not least because when the Total Place approach is factored into consideration of service delivery, the outcomes for services in Norwich and Norfolk could be as good as, if not better than, the outcomes envisaged by the value-for-money services criteria.

Richard Bacon: Is the Minister really saying that the compelling point is that services could be as good as they are at present? What is compelling about having two directors of children's services rather than one? What is compelling about having two directors of planning and transportation rather than one? What is compelling about having two heads of adult social services rather than one? How is that the potent economic reason that is the supposed rationale for this mess?

Rosie Winterton: If the Total Place approach were adopted-

Chloe Smith: Will the Minister explain what Total Place means? I, for one, am in the dark about this bit of jargon and its application to this debate.

Rosie Winterton: Oh dear, how very disappointing. Total Place is about looking about the amount of public money that goes into an area and how efficiencies could be achieved by looking at it in the round. Local government could work with health authorities or the police authority. Her party's Front Benchers are fairly supportive of it as an approach to considering efficiencies.
	When the hon. Member for South Norfolk (Mr. Bacon) came to see me, he pleaded for us to reject a unitary approach for the whole of Norfolk. He objects to Norwich having unitary status, but following his logic he should support unitary status for the whole of Norfolk. Presumably, in his argument, that would avoid any duplication, but that is not what he and his hon. Friends said when they came to see me.

Richard Bacon: The point is that it is possible to achieve the benefits without the costs, the risks and the extra bureaucracy.

Rosie Winterton: That is the judgment made by the hon. Gentleman, but we have made our judgment based on our assessment of the criteria and the circumstances that we have taken into account. We have seen that there are compelling reasons for allowing Norwich and Exeter to have unitary status.

Bob Neill: I am grateful to the Minister for explaining how Total Place came into her reasoning, and she is right to say that we support that approach. But against that background, why did the House of Lords Committee on the Merits of Statutory Instruments observe, after receiving the same explanation from the Department that she has just given to us:
	The committee remains very unclear what value unitary status is supposed to add when similar initiatives have already been set up for each area. The House may wish to seek a clearer explanation from the Minister as to why the Total Place approach is considered a compelling reason for granting each city unitary status.

Rosie Winterton: We believe that the Total Place approach in this case will combine leadership within the authority with the savings that can be made. The benefits of a unitary Norwich for the local economy were judged to outweigh the risks of affordability.

Charles Clarke: Can my right hon. Friend confirm that, in the city of Norwich at the moment, public workers work either for the county or for the city, so there are two separate human resources functions, two separate finance functions and two separate PR functions? People in planning are working entirely in parallel, and social services and social care overlap in a wide variety of ways. Despite the merit of her letter and the advantages in joint working, the reality is that such joint working is not happening today, which is why unitary status would achieve savings.

Rosie Winterton: My right hon. Friend makes an important point. That is exactly the approach that we need to take to this issue. Similarly, in relation to Exeter, I believe that our decision is right, not least because I judge the risks there on affordability are outweighed by the benefits for the local authority.

Norman Lamb: In the Minister's explanation of what is meant by Total Place, she talked about local government working alongside the health service. Three years ago, when the primary care trusts in Norfolk were merged to create one primary care trust for the county, the Government lauded the fact that we now had virtually the same boundaries for health and social care. Now that will be destroyed. Where is the logic in that?

Rosie Winterton: We considered all the reasons why the criteria, in nearly all the cases, were met, but we also looked at affordability, and we believe that there are good examples-this was the point of my letter today-of how we can have joint working in those circumstances. As I have said, we believe that there are compelling reasons for our decision to depart slightly from one of the criteria, and that is the best outcome.

Gary Streeter: The right hon. Lady is coming to the compelling reasons for departing from the criteria in relation to Exeter. What evidence has she received demonstrating why Exeter, as a unitary authority, is likely to be better than Exeter as part of a Devon county council at attracting inwards investment and economic regeneration?

Rosie Winterton: When the hon. Gentleman's colleagues from Exeter city council came to see me, they presented a good case for why Exeter needs some of the economic advantages of having unitary status in order to take some of the necessary strategic decisions. He might like to consult his Conservative colleagues on Exeter city council about why they backed that.

Bob Neill: Which ones?

Rosie Winterton: The hon. Member for South-West Devon (Mr. Streeter) can decide which ones he would like to consult. I am sure that he is perfectly capable of making that decision.

Jim Cunningham: It is not for me to interfere in counties such as Devon, but, listening to the Opposition, it strikes me that they are against unitary authorities in principle. The real reason they are opposed to a unitary authority at a county level is that they are opposed to regional authorities in the first place-they have always protested against them. So we have to see through their argument. They use collaboration with local authorities in general-they are doing it in the west midlands-as a substitute for regional government. That is the real Opposition coming out.

Rosie Winterton: My hon. Friend makes a good point. The other point to make is that the Conservative party has never really grasped the importance of economic interventions, whether at national, regional or local level. Any idea, therefore, of the advantages that there might be for Exeter-

Hugo Swire: rose-

Rosie Winterton: I am going to press on a little, but I will let the hon. Gentleman in later. However, I am aware that a lot of Members want to speak.
	When we announced the decisions, I said that we would be inviting all existing councils in Devon and Norfolk to work together with the Government to develop the new service delivery models that, with the advent of unitary councils for the cities, will enable the best quality and more efficient public services to be provided to the cities and the wider county areas. That is the whole point of the letter that I wrote today. I also undertook to invite all the Suffolk councils, with their Members of Parliament, while consulting other stakeholders, to a county constitutional convention, in order to reach a consensus on a unitary solution for that area.

Hugo Swire: In the event of Exeter getting unitary status, will there be any extra money for Devon county council to restructure itself?

Rosie Winterton: Under our proposals, implementing a unitary Exeter and Norwich will cost £400,000 over five years, but thereafter there will be a saving of £6.5 million a year. As I have said, my point is that we are working with all the councils involved to ensure that they are looking at not only the advantages that can be gained from Total Place, but other ways in which they can work together. When Conservative Members came to see me, they made the point over and over again about how well that working together was going. I find it extraordinary that all that is being turned on its head.

Ronnie Campbell: The Minister talks about criteria. Returning to Northumberland, the criterion then was to save £18 million a year in golden services, but quite the opposite happened after the first year. We have had rate rises, cuts and debt up to our necks. So I do not know where these criteria come from. Everybody should be warned. It might come from the civil service-fair enough-but they should be warned that the things being put in front of them are a pack of lies.

Rosie Winterton: My hon. Friend is so robust, and it is so refreshing to hear his contribution. I thank him for that.
	I turn to the representations that we received orally and in meetings with effective councils and Members of Parliament from this House and the other place.

Keith Simpson: rose-

Rosie Winterton: I will come back to the hon. Gentleman.
	First, let me highlight that the representations we received went beyond the question of whether the proposals would deliver the outcomes specified by the criteria. This included many issues that, in the event, we considered were material to our decisions on Exeter and Norwich. Representations were made that highlighted the wider economic benefits of city unitaries. For example, while recognising that the Exeter proposal did not meet the affordability criterion, representations were made to us that the proposal should be implemented-this goes back to my earlier point-because Exeter city council was the driving force in the area, providing coherent strategic leadership on urban needs, growth and development, and that the two-tier system did not allow urban residents' views and political preferences to be heard at county level.

Keith Simpson: rose-

Rosie Winterton: I give way to the hon. Gentleman.

Mr. Deputy Speaker: Order. Before the hon. Gentleman intervenes, may I say that time is moving on? I understand the need for debate and interventions, but a number of people who have intervened several times are also seeking to catch my eye. I hope that they appreciate that the time taken in interventions means that fewer hon. Members will have the chance to make their own points. I hope that that is understood.

Keith Simpson: The case for a Norwich unitary would be strengthened had it effectively been in care for about the past five or six years and had its accounts been qualified. Any idea-sadly-that Norwich could provide economic leadership is ludicrous. Only last year, the chair of housing had to be sacked for incompetence and what could be best described as corruption. I am afraid that the right hon. Lady's main message about Norwich does not stack up, as the Lords Merits of Statutory Instruments Committee concluded.

Rosie Winterton: I am sorry that the hon. Gentleman has decided to condemn the council in that way. I must say that representations in favour of a Norwich unitary said that the city's urban needs were very different from those of the surrounding rural county, and that only a unitary city council would ensure that those specific needs important for Norwich's growth-for example, jobs, the green knowledge economy and business growth-are recognised and addressed. Representations were made also made to the Secretary of State highlighting the importance and relevance of Total Place to his decisions, as I have said.
	In short, for the proposals for Exeter and Norwich, we concluded that the benefits for the local economy and how services could be delivered across the new unitaries and the wider county areas in the context of Total Place outweighed the risks of affordability. For Suffolk, we concluded that we would not now take a statutory decision on the proposals before us, but invite all the Suffolk councils, along with their Members of Parliament, consulting with other stakeholders and through a county constitutional convention, to reach a consensus on a unitary solution for that area. We reached that conclusion, because it was clear from the representations that we received that although there should be a unitary solution in some form, neither of the unitary proposals that we considered to have met the criteria was supported by all the principal councils in the county. We wanted to try to reach a solution on the basis of consensus.

Several hon. Members: rose -

Rosie Winterton: I will give way to the hon. Member for South-West Norfolk (Christopher Fraser), because I have not taken an intervention from him yet, but then I want to move on quickly.

Christopher Fraser: I am listening carefully to what the Minister is saying, but if I have got what she has just said right, how can the Government reconcile the unaffordability of the original Norwich city bid with the decision to take it forward regardless? How does she see the affordability problems that were initially identified being overcome? If she could respond in detail for us all, I would be most grateful.

Rosie Winterton: That is exactly the point that I have spent about the past 20 minutes on. We have taken our decision based on the evidence currently before us, which is why we judged that the economic benefits, combined with the Total Place approach, would give the outcome that we wanted.

Caroline Spelman: I appreciate the Minister giving way, but could she explain why the Government have chosen to pilot Total Place across county boundaries, including in cities? The Total Place pilot for Coventry, Warwickshire and Solihull precisely demonstrates that the benefits accruing from the Total Place model are certainly not confined to just one city.

Rosie Winterton: I do not understand the point of that intervention. If the hon. Lady is saying that there are benefits from Total Place-which she might like to tell her hon. Friend the hon. Member for Bromley and Chislehurst (Robert Neill) about-it is obvious that they would count in that respect.
	Let me now turn to the direction that the Secretary of State gave to the Department's accounting officer on 10 February. There are two issues that I would like to deal with. First, the process of seeking a direction is a standard part of the administrative processes of government, and one that recognises that accounting officers have certain responsibilities and that Ministers' responsibilities range more widely. In short, it was proper for the permanent secretary, as accounting officer for the Department, to draw attention to the fact that Ministers had not chosen the option that appeared to him to deliver the best value for money. However, it was equally proper for me and the Secretary of State to adopt the approach that we have, and to set out our reasons for those decisions. Of course my right hon. Friend and I gave careful consideration to the permanent secretary's advice before taking our decisions on all the proposals, recognising that accounting officers have certain responsibilities and that Ministers' responsibilities range more widely.
	Let me turn to the accusation that now is not the right time for such important decisions to be taken because we are in some kind of pre-election period. We need to be clear about our conventions. Until an election is called, the Government of the day have both the duty and the right to pursue and implement the policies that they believe are best for the people of this country. Likewise, Parliament continues to have the duty and the right to scrutinise those policies and, where legislation provides for this, to decide whether or not to approve them. It would be wrong for us at this stage not to face up to our responsibilities and take the decisions that we have. It would be equally wrong for Parliament not now to consider them. In the meetings that right hon. and hon. Members attended, we were told over and over again, Please take a decision quickly on this, so that there is an end to uncertainty.
	To conclude, we considered each of the unitary proposals before us on its merits. We did not accept any implication that the public interest lies with adopting the cheapest option across all three counties. We adopted the approach whereby we carefully assessed each proposal against the five criteria. In all circumstances we gave careful consideration to whether there were compelling reasons to depart from the presumption that proposals that meet the criteria are implemented and that those that do not are not.

Richard Younger-Ross: The right hon. Lady talks about the cheapest option, but that will lead to pressure on council budgets. Representations were made to her Department that such budgetary pressures would lead to an inability to employ staff of the necessary quality, because of being unable to pay for higher grade staff that other authorities can pay for. Exeter will have exactly the same problem that other small authorities have had, in relation to having the right calibre of staff to undertake the necessary functions. This decision is not going to do Exeter a service; it will do it a disservice.

Rosie Winterton: The hon. Gentleman might like to discuss this with his colleagues on Exeter city council who are, as I have said, strongly in favour of having unitary status.
	We are clear that the decisions that we have taken on the unitary proposals for Devon and Norfolk are in the best interest of the people of those areas, and that there is a genuine local appetite for the measures. We believe that these decisions will give the cities of Exeter and Norwich the governance arrangements that are best suited to deliver economic, social, and environmental success for the cities and their surrounding areas. We have listened carefully to what people have said; we have considered carefully the evidence available to us; we have weighed the competing cases that we have heard; and we are confident in the judgments that we have made. I therefore urge the House to reject the motion and support the amendment in the name of my right hon. Friend the Prime Minister.

Daniel Rogerson: We find ourselves involved in the second instalment of a three-round discussion on these proposals. Thanks to the hon. Member for Mid-Norfolk (Mr. Simpson), we had an opportunity to discuss them in Westminster Hall last week, and the order itself will be discussed in Committee within a matter of days. In Westminster Hall, however, we did not have the benefit of the Minister's view of where we had got to. As has been pointed out, the advice that she is sending out to councils appeared in writing a few hours ago. I hope that we will hear a slightly more cogent argument-[Hon. Members: And some evidence.] Absolutely. We need to hear the evidence for why these proposals had to be brought forward at this juncture and rammed through before the general election. Sadly, however, I do not think that we are any further forward than we were at the conclusion of the proceedings in Westminster Hall.
	As the Minister rightly said, this has been a lengthy process, but the problem is that throughout it, the goalposts have continually been moved. It started with a tight fixed time scale, and other parts of the country wished to participate in the process at that stage. Bids from those areas therefore came forward quite rapidly, but they might have been of a different nature if there had been more time to consider which proposals were most appropriate. Those areas were under the impression that that was the only game in town, however. It then transpired that that was not the case.
	The next process entailed the boundary committee for England being asked to get involved, if the Government were unhappy with the bids. The boundary committee then looked at the evidence and came up with proposals for unitary counties, with which no one in the counties concerned was happy. There really was not a huge argument for unitary authorities in those areas.

Adrian Sanders: The process was flawed right from the beginning. Four out of every 10 homes in the county of Devonshire were not involved in the process, because the people who live in Plymouth and Torbay were not allowed a say, even though the proposals will have an impact on them.

Daniel Rogerson: My hon. Friend is absolutely right. This is the problem with the process. The hon. Member for Bromley and Chislehurst (Robert Neill) talked about the arguments for and against unitary authorities, and he was right to say that people take different views. In my view, there is a strong case for unitary government where the boundaries make sense. However, it is ludicrous for the boundary committee-which was not involved at the start of the process; that was something that the Government hit upon halfway through-to draw lines round parts of an area and say that they should not be included.
	We should look at the case of Torbay in passing, because many people would describe it as a unitary authority that was bound to fail, because it is quite small and tightly drawn. It is difficult, under any administration, for a small unitary to deliver its services effectively, for all the reasons that hon. Members will no doubt wish to talk about tonight.

Richard Younger-Ross: If we look at Torbay or Devon, and officers working for one or the other, we see that they can work for either a small unitary authority or for a very large county authority. Which does my hon. Friend think will be able to pay the better salary and provide the better promotion prospects for anyone working for these authorities?

Daniel Rogerson: That reinforces a point made in an earlier intervention, and I accept that there are many factors that need to be taken into account.
	Unitaries are proposed-and indeed accepted by the Government-in dubious circumstances, as already mentioned, for two parts of the counties involved, but the third county of Suffolk, which has not yet been much debated, has been offered the possibility of having a county constitutional convention. My hon. Friend the Member for North Norfolk (Norman Lamb) said publicly at the beginning of this process that he felt that this would be a way forward for Norfolk. If people across Norfolk had had the opportunity to make proposals with the prospect of gaining some measure of consensus, this might well have been an entirely different exercise.

Charles Clarke: The hon. Gentleman talks about attitudes to this issue and the idea of having a convention, so does he concede that the leader of the Liberal Democrat group on Norwich city council, Councillor Brian Watkins, and his colleagues, and my Lib Dem political opponent at the general election, Simon Wright-this is the 24th Lib Dem target seat in the country-both strongly support the unitary option for Norwich? Will the hon. Gentleman support them in that? When he decides what he is going to do tonight, will he support them or do something that effectively stabs them in the back in their efforts to put their views forward?  [Interruption.]

Daniel Rogerson: I think that the hon. Member for South-West Norfolk (Christopher Fraser) is making a point from the Back Benches, which may be on the record.
	It is clear that in all political parties, people have different views. For anyone active in opposition, in government or seeking to get there, one has to look at all the evidence relating to the case. There are preferences in certain local areas and parts of counties for particular proposals, as people feel a great loyalty to the institutions to which they are elected. That is one consideration, but far more importantly, we must judge how effective any unitary authority created within these boundaries would be. That is where the proposals before us are called into question.

Norman Lamb: My hon. Friend's answer to the right hon. Member for Norwich, South (Mr. Clarke) was perfect. The reason why I put forward the case for having a constitutional convention was that I could see a Stalinist process emerging that would completely ignore the people of Norfolk. I thought that there would no process to engage people about the future of local government for our county. I am not instinctively against unitary government at all; I think that it makes a lot of sense in many ways. The problem is that the people of Norfolk have been ignored in this process, which is why it caused outrage.

Daniel Rogerson: I thank my hon. Friend for that contribution. Looking at Devon, for example, it is important to point out that the position already mentioned in respect of Torbay and Plymouth and the surrounding area was brought about under a Conservative Government. In those areas, the job was only half done and left hanging by the Conservative Government, whereas we should have considered proposals relating to the whole county of Devon. There was an opportunity in Devon's case to examine the circumstances, look afresh and see what could have been done slightly better or differently. As has already been pointed out, however, that offer was not on the table.

Richard Bacon: We should have warned the hon. Gentleman before that although the right hon. Member for Norwich, South (Mr. Clarke) looks cuddly, he is actually the sort of bull who brings his own china shop with him. The hon. Gentleman should sup with a long spoon, but will he acknowledge that we on the Conservative Benches are not at all surprised by what he said? As already mentioned, we are familiar with Liberal Democrats whose backsides are nailed so firmly to the fence that the iron has entered their soul, and they not only say different things in different parts of the country, but, even more commonly, say different things at opposite ends of the same street.

Daniel Rogerson: If the hon. Gentleman had listened to what I said earlier, he might not have risked returning to the issue of splits in his own party over these issues. Throughout our earlier debates on the creation of unitary authorities throughout the country, we heard his colleagues on the Conservative Front Bench saying that it was a terrible process without really engaging with the fact that the unitary authorities that now exist in Wiltshire and Shropshire were proposed by the Conservatives.
	The point is that people should be able to come forward and present proposals for measures that will work in their areas, and the Government should be able to decide whether those proposals stack up financially. Different considerations will apply in different parts of the country. Some of the larger unitary authorities may not meet with favour locally, even if they are more financially viable.

Julia Goldsworthy: As my hon. Friend has said, the experience of the process has been difficult for all parties. I well remember our debates on some of the unitary authorities that now exist, when there were divisions between all the parties. I think that this is a missed opportunity. If we want to engage people in politics, should we not encourage them to unite on the changes that they want rather than being fractured over those that they do not want?

Daniel Rogerson: As always, my hon. Friend has made a good point. We are having this debate against the background of a general election, rather than pushing the issues into a future time when they could be discussed more calmly. We are working to a timetable of the Prime Minister's rather than the Department's choosing.

Norman Lamb: I must respond to the outrageous goading by the hon. Member for South Norfolk (Mr. Bacon), whom I would almost call my hon. Friend. The Conservative county group, which supported a unitary Norfolk, was opposed by Tories in district councils across the county. The Tory party in Norfolk was split completely down the middle, and the leader of the Conservative county council was deselected as a result of his support for a unitary authority. We will take no lessons from the hon. Gentleman on this issue.

Daniel Rogerson: My hon. Friend has confirmed what I said earlier. All the parties have understandably found themselves having an internal debate, because people in different parts of counties are bound to take different views. It would have been more helpful if, at the start of the process, everyone in the areas concerned had been allowed to discuss the issues through a constitutional convention. A constitutional convention has, in fact, been proposed in Suffolk, but more for reasons of desperation than might have been the case had it been proposed at the outset.

Hugo Swire: The hon. Gentleman mentioned division within parties. He will know that the Labour leader of Devon county council, Saxon Spence, has said that the system is unworkable in Exeter. Indeed, even some Conservative members of Exeter city council who are in favour of unitary government in principle recognise that this is not the time for it because of the changed economic circumstances, and because they see it as a party political move by the Labour party for the benefit of the right hon. Member for Exeter (Mr. Bradshaw) and no one else.

Daniel Rogerson: The hon. Gentleman seeks to build on a point made by the hon. Member for Bromley and Chislehurst (Robert Neill) about potential gerrymandering. I recall that Governor Gerry's name was mentioned earlier. However, I fear that the Government's action may be mistaken, because I do not think that it is particularly to their advantage in either case.

Bob Neill: Bad gerrymandering.

Daniel Rogerson: Absolutely. It is the worst of all worlds. The Government are trying to gerrymander in a way that does not work in their own interests, let alone anyone else's.

Christopher Fraser: Does the hon. Gentleman accept that the Conservatives in Norfolk are united on one issue-the delivery of good services to the people of Norfolk at a sensible price? Anything that adds cost is anathema to all Conservatives, whatever the level at which they represent people in Norfolk.

Daniel Rogerson: The hon. Gentleman was dangerously close to saying that they were disunited on every other issue. We have had quite a debate already, and the issues that seem to be resolved are that unitary authorities on the scale proposed will have real difficulty in delivering services effectively, and that there is a huge question mark over the process that has been followed. Local people in those areas, regardless of what their views may have been at the beginning of the process, will feel that they have been served badly by that process, which has been done to them, as opposed to being one in which they have been engaged.
	I should pick out one slight inconsistency in the Conservative position. The hon. Member for Bromley and Chislehurst (Robert Neill) referred to academic research, in particular that by Professor Chisholm, showing that unitary local government and the transition to local government is problematic. A great deal of research shows that this can work effectively, so I have a problem with the motion, which in effect says that there are question marks over the whole process of transition to unitary authorities. That is not defensible.

Bob Neill: The point that I was making was that the academic research by Professors Chisholm and Leach demonstrates that the methodology adopted by the Department for Communities and Local Government in relation to the current round of unitary restructuring is highly suspect.

Daniel Rogerson: That clarification is helpful-not that that dimension would have encouraged my hon. and right hon. Friends to have voted against the motion anyway, because we feel that common sense should reign, and we should have the opportunity to point out how the process has been flawed throughout. None the less, I am glad of the clarification, because unitary local government is beneficial in areas where those who create it get it right, where the boundaries are sensible, and so on.
	In summary, the Liberal Democrats' position is that although we feel that there is a case for unitary government in many parts of the county, the proposals being pressed by the Government in this unseemly way just before a general election are not helpful, and we shall therefore be happy to vote for the motion.

Several hon. Members: rose -

Madam Deputy Speaker: Order. May I remind hon. and right hon. Members that Mr. Speaker has imposed an eight-minute limit on Back-Bench contributions? I call Dr. Starkey.

Hon. Members: She's not from Norfolk!

Phyllis Starkey: I note, Madam Deputy Speaker, that Conservative Members appear to be challenging your ruling in calling me, and I sure that they did not intend to do that and would wish to rephrase their sedentary comments.
	When listening to the peroration of the hon. Member for Bromley and Chislehurst (Robert Neill), I felt that he had lost his knowledge of what had happened in the past on local government reorganisation. I simply point out to him the experience that many of us had of the Banham reorganisation under the previous Conservative Government. Although it is true that criteria were used then, the point is that the criteria were simply different as the commission progressed around the country and it was never terribly clear which set of criteria the Banham commission was using when it came to the area in question.
	I had direct experience of that as the then leader of the Labour-controlled Oxford city council. The council came to an agreeable arrangement with the four Tory-controlled district councils in the rest of the county. A very civilised discussion was held and we reached an agreement, which we presented to the Banham commission, on a proposal for three new unitary authorities. We understand that although we made an excellent case-each of us had the support of all the parties within each council and of a very large proportion of the population in each council area-at the last minute the proposal was rejected largely because of the principled, or unprincipled, intervention of the then Member for Witney.
	Other cities across the country had their own experience of the Banham reorganisation, when similar political considerations were considerably more powerful than the stated criteria against which everybody was operating. All the strictures given by the hon. Member for Bromley and Chislehurst about the process ring rather hollow given that, frankly, 'twas always thus and 'twill always be so. There will always be political considerations and it ill behoves Conservative Members to pretend that it happens only under Labour Governments and never happened under Conservative Governments. I also point out that it was under the previous Conservative Government that unitary authorities were imposed on Scotland and Wales without so much as a by your leave or any semblance of consultation. Pots and kettles come to mind.
	I found the peroration of the hon. Member for Bromley and Chislehurst very strange when set against the Conservative party's avowed commitment to localism, which appears to have a completely different meaning when it is applied to the desire of Exeter and Norwich to be unitary authorities and seems to stretch to the whole of a county. That is not normally what people out there believe to be localism.
	The overriding priority for the Opposition, it would appear, is the cost of the arrangements. There is no consideration for democracy. I am sure that if we scrubbed every local authority in the country and, indeed, this Parliament and just had a dictatorship, it would be immensely cost-effective and hugely cheaper than the democratic system that we operate in this country, but nobody-not even the Conservatives, presumably-would pursue cost-effectiveness to that level. There is a balance to be struck between democracy, localism and community identity, and cost. To simply say that the only thing that matters is cost-effectiveness seems to me not to run with the avowed commitment of the Conservative party to localism. It rather suggests that localism, as far as the Conservatives are concerned, is only about planning and stopping housing and not much about anything else.
	Let me turn to the issue of Exeter, as I know that at least one of the Members of Parliament for Norwich will doubtless speak about Norwich, if called. Opposition Members were suggesting, I think, that the Conservative councillors in Exeter were perhaps not as committed to the unitary status for their city as they had been before. I have a letter dated 2 March, which is not very long ago, signed by the leader of the Conservative group and the Conservative chairman of scrutiny resources of Exeter city council. It makes it quite clear:
	An independent Exeter, with its own government, elected by and in touch with its own people, can make such decisions much more successfully. The city's voters will enjoy a much clearer idea of where responsibility lies and who to go to for help and advice.
	A single-tier authority will cost less in the longer run...and enable the new council to focus on generating the prosperity which will benefit both Exeter and the surrounding county of Devon.
	That is the view of local Conservative councillors on Exeter city council. It is also the view of the other groups on Exeter city council and I am surprised that Opposition Members have been laughing at that and belittling the views of their colleagues in the Conservative party, who are standing up for their city of Exeter.

Hugo Swire: I think that we know slightly better than the Chairman of the Select Committee what our councillors in Exeter are thinking, and most of them think that this is entirely party political and that it is not the right time, economically, to waste vast amounts of money. Is she aware of what the leader of the Labour group of councillors on Devon county council thinks about Exeter going unitary at this point?

Phyllis Starkey: I am sure that the hon. Gentleman can tell me, but I am talking about Exeter. He is talking about a county council that is seeking to impose its views on the city. He is belittling the views, published in the local newspaper in Exeter, of two Conservative Members of Exeter city council. He is in danger of suggesting that those Conservative councillors are writing one thing in their local paper and saying another in private to other Conservative members.
	On unitary authorities in general, I have always been a supporter of unitary authorities, including when I was the leader of Oxford city council. I am even more strongly in favour of them now that I am a Member of Parliament for Milton Keynes because I have seen the huge difference that it has made to Milton Keynes to have a unitary authority and not be part of Buckinghamshire, which never looked after the interests of Milton Keynes, which has a wholly different population to the rest of Buckinghamshire with a wholly different culture.
	Cost considerations are important, but the huge benefits to Milton Keynes and other unitary cities of having councils that focus singly on the issues of those urban areas, that are clearly accountable to the populations of those areas and that work with other service providers in those areas override mere cost considerations. I absolutely understand why councillors in Exeter and the majority of councillors in Norwich want unitary status. Unlike Conservative Members, I believe that those cities would benefit enormously from that focus if they were to get unitary status, and I do not think that the surrounding counties would be impoverished at all. Buckinghamshire is much happier without Milton Keynes, just as we are happier not to be part of it, and I think that the same would be the case in Exeter, Devon, Norwich and Norfolk.

Keith Simpson: I want to speak on behalf of my constituents in my constituency, which wraps around the northern outskirts of Norwich. I have spoken on this issue in three separate debates in Westminster Hall and I am obliged to make a few points on it now.
	I must say to the hon. Member for Milton Keynes, South-West (Dr. Starkey) that this is not just about cost and money. It is about democratic deficit, as my constituents were never asked their views. The Bill by which the unitary authority is being established specifically excludes constituents. Stakeholders, business groups and all kinds of quangos-but not our constituents-may be consulted. The only test that we have ever had, although I accept that it was not objective, showed that, if anything, the overwhelming majority of people in Norwich and the rest of Norfolk preferred the status quo.

Julia Goldsworthy: Does the hon. Gentleman agree that parish councils, which are an important part of local democracy as they are the closest to the communities that they serve, have been specifically and explicitly excluded from the process?

Keith Simpson: The hon. Lady is absolutely correct.
	If the change goes ahead, certainly in Norwich-I shall not comment on Exeter-it will have an impact on my constituents and, I suspect, on constituents in other parts of Norfolk. First, there will be disruption and many services will be duplicated. Also, the financial criteria do not seem to add up. The fact that the House of Lords Merits Committee attempted to get further details and that the Department was unable to provide them stacks that up. The process has been a disgrace from the very beginning, and Ministers have finally produced the orders in desperation, but it is wrong to go ahead with them just before a general election. The Government have no manifesto claim on this issue at all. I suspect that the majority of people in Norfolk will judge the change on whether it delivers better quality services and whether their council tax goes up.
	In an intervention on the Minister, which she kindly took, I said that the argument for a unitary Norwich would be strengthened if it were a five-star council-if it were Norfolk county council-but, sadly for the people of Norwich, it is not. It has always struggled. It has had poor leadership, it has not been able to manage its accounts and it has had all kinds of major problems. I honestly cannot see that a Norfolk unitary authority will be the engine to drive forward any form of future economic expansion for Norfolk. If anything, in fact, past criteria show that it will be a sheet anchor and that it will have an immediate impact on my constituents.
	I shall make one final point, as I know that other hon. Members wish to speak. The Minister and her colleagues have made great play of the fact that the permanent secretary is there only as an adviser but, as my hon. Friend the Member for South Norfolk (Mr. Bacon) said, he is actually the accounting officer. There is ministerial responsibility to consider. The whole issue should be referred to the National Audit Office and the Public Accounts Committee, and Ministers should be held responsible-both personally and financially-for these decisions. What has happened has been shown, by both the permanent secretary and the Merits Committee, to have got close to breaking the law. I hope that Ministers will be held personally responsible. I also hope, in the event of a change of Government, that future Ministers will look into this matter and make certain that those people are held responsible.

Charles Clarke: I am delighted that this debate is taking place. First of all, and following the remarks of the Chair of the Select Committee, it is important to say that it directly affects the constituents of just three constituencies-my constituency of Norwich, South, and the constituencies of Norwich, North and of Exeter.
	There may be indirect effects on other constituencies, and the hon. Member for Mid-Norfolk (Mr. Simpson) has suggested that his might be one, but I do not believe that the argument has been made. In the case of Norfolk, the Opposition have to make the case that the services provided by a new Norfolk county council that is 85 per cent. the size of the current authority would be significantly less good and represent less value for constituents than now. I do not believe that that argument has been made.
	In the Westminster Hall debate on this subject, the hon. Member for South Norfolk (Mr. Bacon), in trying to answer that question, said that he thought there might be some future land grab. I say that that is a matter for the future, and that if his party were fortunate enough to be in office it could see the problem off at any time. In all seriousness, I believe that the case for damage being done elsewhere has not been strongly made.
	The Conservatives have argued the case for unitary authorities since 1986, when the Conservative Government abolished the Greater London Council, the Inner London Education Authority and the six metropolitan county councils, and created 68 new urban unitaries. In 1994, the Conservatives did the same thing again in Scotland and Wales, and then in England the Banham commissioners -to whom my hon. Friend the Member for Milton Keynes, South-West (Dr. Starkey) referred-broke down counties such as Avon, Humberside, Hereford and Worcester, and Berkshire into smaller unitaries. I am glad to say that, from 2008, this Government have taken the process forward.
	In all those cases, the key point that is not accepted by the Opposition is that new authorities were created, with new councillors and officers to deal with the new situation. That was the moment for improvement. Of course, there were historic issues, and by no stretch of the imagination do I seek to defend all that happened, but that new situation is what we are debating this evening. As a result of the changes, many unitary authorities were created that were significantly smaller than Norwich-I will not list them all now, but they include Hartlepool, Darlington and Bracknell Forest-and that leads me to believe that it would be entirely possible to establish an effective new authority for Norwich.
	In summary, for 20 years there has been a strong and continuing tide towards unitary local government. The quality has been good, and the move has been supported by the Conservative as well as the Labour party. Of course there have been many local issues-some of them bitter-as private power bases have been dismantled and uncomfortable, but necessary efficiency changes driven through.
	I was interested in the remarks by the hon. Member for Bromley and Chislehurst (Robert Neill) in that regard. I do not want to misinterpret him, but he made it very clear that, if he were in office, he would propose no new unitaries if they had to be imposed against the wishes of other people. I take that to be a commitment that a future Conservative Government would never put in place a unitary Norfolk county council if there were opposition from districts in Norfolk. I also noted that he made no commitment to overturn in future any decision that had been made.

Richard Bacon: The Audit Commission has described Norwich county council's financial management as not fit for purpose. Given that, I cannot understand how a unitary Norwich could be the engine-what the Secretary of State called the potent force-for anything.

Charles Clarke: For three reasons. First, as I said, it will be a new council-that is important-all-out elected in 2011, with new chief officers and a new situation. Secondly, I believe that there will be genuine economies in various areas as a result of a unitary authority with services working together. Thirdly, the performance of the city council over recent years has been improving significantly from a very bad position, as the hon. Gentleman and others have rightly identified. The case for unitaries is powerful.

Bob Neill: In endeavouring to be helpful, I did not want to inadvertently mislead the right hon. Gentleman. I must confess that I omitted something. I should have stated what I have stated so many times before elsewhere: of course, in office, we on the Conservative Benches will reverse this ill-considered decision.

Charles Clarke: I am glad the hon. Gentleman has made that clear. I thought that with great subtlety he had ducked the point and not carried it through. I thought there had been a shift of policy, so I am glad he has clarified that.
	The reason for unitary local government is that it is much more efficient than two-tier government. It is far more effectively co-ordinated and coherent. The value for money that it offers is far higher, the costs are lower, and the decisions taken by unitary local government are more transparent and much closer to the citizen. We can see the reason for that in Norwich today with the decisions being taken by the county council. The desire for unitary status has been massively increased, even in recent months, by a number of bad and irresponsible decisions taken by the newly elected Tory county council in 2009.
	First, the county council has decided to close two important social facilities for the elderly, the Essex rooms and the Silver rooms. It has no idea what commitment to give to support the frightened users of those services or what to do with the facilities. It is in an absurd position, which is so serious that the hon. Member for Norwich, North (Chloe Smith) says that she opposes the council's proposals-she has said that publicly-because those proposals come from people who know nothing whatsoever about Norwich.
	Secondly, the county council has decided to reduce the amount of money that it gives to urban schools, including in Norwich, which do not fit in with its county-wide priorities, because it is not concerned. Thirdly, unbelievably, the council has decided to turn off the street lights throughout my constituency between midnight and 5 am, on the grounds that what is all right for small rural villages is also okay for major urban centres. It is a ludicrous decision. It is no surprise that the decision is spreading fear across my constituency. Even my Tory opponent, Councillor Anthony Little, has started distributing leaflets expressing his concern, as he misleadingly implies that that has been a decision of the Labour city council rather than of the Conservative county council, because it is such a bad decision.

Chloe Smith: The right hon. Gentleman may be aware that the county council is not doing as he has just suggested. As my hon. Friends have mentioned, that is rather more a spiel than a point. The decision on street lights was delegated to the director of transportation planning, as the right hon. Gentleman well knows.

Charles Clarke: I beg your pardon. The Tory county council has decided to ask the director of planning, Mike Jackson, to take the decisions because it wants to run away from the responsibilities. It is extraordinary.
	My final point is that Norwich is already among the top five shopping centres in the country, and we want to achieve even better shopping centres, so the decision is taken-recommended by that same officer, by the way-to pedestrianise the Westlegate area in my constituency, which five Tory county councillors from out in the sticks have said they want to block.
	I cite these four examples not just because they are bad decisions, which they are, but because each of them is a decision which should properly be taken by the city council, by people who are accountable to the electors there, rather than by people who live as much as 50 miles away from Norwich and have absolutely no idea of the condition of life in the city that is Norwich. It is a ludicrous state of affairs.  [Interruption.] That is why there is support across the whole of the city for the proposals that are being made. It is not just the Labour party- [Interruption.] It is the Liberal Democrats, the Greens-

Madam Deputy Speaker: Order.

Charles Clarke: I put a simple challenge to the Opposition parties. Let us add up the votes cast on general election day for the candidates in Norwich, South and Norwich, North, according to their attitude on unitary status. I predict we will find that the overwhelming majority of votes have been cast for candidates who support unitary status in Norwich. I hope that will be honoured. That is a central point in the debate.
	Under the current arrangements, which the Opposition support and want to maintain, those decisions will continue to be taken by a county council covering an area-the county of Norfolk-with 85 per cent. of the population size of Birmingham. It is large enough to contain the whole of Greater London twice, parts of the county are more than 50 miles from Norwich and it stretches 75 miles from one end to the other.
	We are talking not about a tiny, coherent, local community, but about a state of affairs in which people do not have a purchase on the key decisions in their life. Increasingly, the county council, which was elected in 2009, takes decisions that take not the slightest account to the needs of my constituents. For the judicial review, it has even retained solicitors based in Tunbridge Wells, rather than the excellent solicitors based in Norwich, so much does it care about building the legal system in Norwich.
	I have strived and supported unitary local government throughout the county; I have favoured a unitary Norwich that is based on boundaries that reflect the actual built- up area of the city, because the divergence with Norwich is greater than that of any council in the country; I have opposed a unitary Norfolk on the ground that it is far too big to be properly responsive to local communities; and I had hoped and expected that the boundary committee would emerge with a proposal that commanded general support, as I believed was possible.
	It was an incompetent process that left the Secretary of State with an invidious choice between a unitary Norfolk, which even the Conservative county council formally opposed, the status quo and a unitary Norwich on current boundaries. He has taken the right decision, which should be supported in the Lobby tonight and when orders are put before Parliament later on.

Henry Bellingham: It is always a pleasure to follow the right hon. Member for Norwich, South (Mr. Clarke), but as he rightly pointed out the whole process has been a complete shambles. There has been relentless political involvement and interference in the process throughout, and that is a disgrace. The role of the boundary committee is one of a quasi-judicial body, and we should be very concerned about such political interference in its workings.
	The restructuring is a political fix, at the fag end of a Parliament, to try to save the constituencies of one Cabinet Minister and one former Cabinet Minister, and depressingly, as the hon. Member for North Norfolk (Norman Lamb) outlined in an intervention, the cost of the process has been huge. The cost in terms of the paralysis in decision making, the diversion of management time and the judicial challenges involves money that could have been spent on local services-on the very services that the right hon. Member for Norwich, South mentioned. They are under pressure because of this Government's woeful mismanagement of the economy, and that money could have been spent helping our constituents.
	One thing that has really struck me over the past two years is the extent to which decisions, even in the west of the county, have been put off or delayed because of uncertainty, and the Government knew that that would happen. Norwich city council is still dysfunctional; it is financially incontinent, as my hon. Friend the Member for South Norfolk (Mr. Bacon) pointed out; its accounts have not been properly signed off; and it has not had a clean bill of health from the Audit Commission. The right hon. Gentleman said that the council has improved enormously, but only a year ago there was a very serious housing scandal, so for him to say that the council has improved so much that it is ready to go unitary beggars belief.
	Of all the councils in the country, Norwich city council is the one that should not be given unitary status. It has never been pro-enterprise, pro-jobs or pro-initiative, and for the Minister to say that something has dramatically changed since the original boundary committee report, and now she is absolutely convinced that this is the one council that can drive the jobs and enterprise agenda, is absolutely staggering. As my hon. Friend the Member for Bromley and Chislehurst (Robert Neill) pointed out, the Department's permanent secretary, who after all is the accounting officer as well, clearly made the point that the argument in terms of jobs and the enterprise initiative is sparse and hollow.
	Looking at it from the point of view of someone who sits for a constituency in the west of the county, I have to say that people in my constituency want the status quo. They want a county council that is able to deliver top-quality services. This is a beacon council-one of the very best in the country-that is delivering top-quality services in conjunction with the two-tier system. I also have a top-quality borough council in King's Lynn in west Norfolk. The status quo is working well, although it can work better, of course, through more partnerships and joint enterprises between councils.
	Hon. Members might have seen that the Electoral Commission was extremely sceptical and scathing about the postponement of the elections. I fear that if these changes are forced through in the fag end of this Parliament, we will be faced with a county council that will lose part of its council tax-raising base, and services will suffer in my constituency and in other constituencies. This is a complete farce and a disgrace, and it has to be stopped; we have an opportunity tonight to go into the right Lobby and stop it.

Anthony D Wright: I am 100 per cent. behind unitary authorities. Indeed, I am envious of the position that Norwich finds itself in of being offered the opportunity to have unitary status. My hon. Friend the Member for Waveney (Mr. Blizzard) and I were fully supportive of a unitary authority for Great Yarmouth and Waveney, but that was not to be the case. We held that position some 13 or 14 years ago, when my hon. Friend and I were leaders of those respective councils and we were told, under the Conservative Administration, to look positively towards a unitary authority in which both those authorities would come together. We have been actively seeking the opportunity to take that forward, but have been prevented from doing so.
	I accept that in the three years that have passed with the matter going backwards and forwards in the boundary committee, the situation has been flawed in many respects. However, we were let down very badly on the question of why Great Yarmouth and Waveney were unacceptable as a unitary authority. The boundary committee said that both local authorities were weak in political leadership and financial management. Opposition Members have claimed that that is so in Norwich, South. I ask the Minister to respond on the opportunities that there may well be to open up the matter again following the election of a Labour Government at the next election.
	Opposition Members, including the hon. Member for South-West Norfolk (Christopher Fraser), have said that Norfolk county council is delivering good services. However, the history in Great Yarmouth means that I differ from that point of view. Five or six years ago, the council closed village libraries in my constituency, despite opposition from the public and Conservatives on the local authority. It is trying to downgrade Gorleston fire station by taking away the retained firemen and replacing them with a crew from Yarmouth fire station. That is an absolute disgrace. Political opponents are trying to make out that it is a plan by the Labour Government, yet it is down to the fire committee of Norfolk county council.

Christopher Fraser: How does the hon. Gentleman justify the extra cost to the taxpayer of a new unitary status for Norwich, which is not accepted by the rest of the county but which the rest of the county will be paying for?

Anthony D Wright: I do not think that the rest of the county has put its views forward on that, and the hon. Gentleman is not justified in saying that there will be such extra costs.
	I am looking forward to somebody promoting and supporting the concept of unitary authorities. I live in hope that one day in the very near future Yarmouth and Waveney can join together in a unitary authority and bring value for money and decent services to my constituents in Great Yarmouth and those of my hon. Friend the Member for Waveney in Lowestoft.

Phyllis Starkey: Does my hon. Friend accept that the point that Opposition Members have made both to him and to my right hon. Friend the Member for Norwich, South (Mr. Clarke)-that the formation of a unitary authority in Norwich would somehow cost everybody else in the county much more money-can only really be true if the county council is taking considerably more income out of Norwich to subsidise services in the rest of the county than it is spending on services in Norwich?

Anthony D Wright: My hon. Friend makes a valuable point about value for money. I do not believe that the situation that she describes is the case. I have a fear for the future, which is that a Norfolk without Norwich will leave us somewhat devoid of democratic accountability. I am concerned that we will be left with the two-tier system in the rest of the county council area, which will still fail to deliver services in my area. That said, I firmly believe in the concept of unitary authorities as the way forward.
	The switching off of lighting after midnight has been mentioned, and it is happening at a time when safety is of paramount importance. Crime levels have reduced extremely fast in my constituency, and the change will put that in jeopardy. Where was the consultation with my constituents before the decision was taken? There was none whatsoever.
	It is time to move on. Previous Conservative Administrations have accepted the concept of unitary authorities, and we should push ahead with this one. I accept that the boundary committee has taken decisions that could be questioned. I have suggested to it on several occasions that a unitary authority in my constituency would have worked extremely well, but we have to move on from that. I support the concept that Norwich deserves unitary status, and I believe that the rest of Norfolk should move on and work towards unitary authorities in the rest of the county.

Norman Lamb: The Minister for Regional Economic Development and Co-ordination said that the Secretary of State had concluded that it is in the best interests of the people of Norfolk to go with this proposal. I regard that as high-handed arrogance of the worst sort, particularly as the people of Norfolk have had no opportunity at all to express our view through the entire process.
	To take up the point made by the right hon. Member for Norwich, South (Mr. Clarke), I acknowledge that there are strongly held views on both sides and that some people genuinely argue with some passion for a unitary Norwich. I have no objection to the principle of unitary local government, although I have to correct one thing that the right hon. Gentleman and the Chairman of the Select Committee, the hon. Member for Milton Keynes, South-West (Dr. Starkey), said. They argued that there is overwhelming evidence that unitary local government always produces good results; it does not. The Audit Commission tells us that the evidence is mixed. Some unitary authorities have worked very well and others have not, and the most important factor is the size of the local authority, whether it is unitary or two-tier. Larger local authorities tend to perform better than smaller ones, which is the concern in the case of Norwich.
	I profoundly disagree with the decision that the Government have taken, and I will do what I can to oppose and block it. It is an outrage that deserves to be dumped as quickly as possible. The process that has led to this point has been scandalous, and it has been the most appalling waste of public money. That is partly because of the evidence-building exercise by a body that the Government created to conduct the process, but we must also take into account the money spent on lobbyists by councils on both sides of the debate and on lawyers in legal actions and judicial reviews. All that money-millions of pounds-should have been spent on delivering services to vulnerable people in Norfolk at a time when services in local government are under intense strain because of the state of public finances. It is a disgrace, and the Government should be condemned for it.

Charles Clarke: The hon. Gentleman has said that he will use his powers to block the proposal in whatever way he can. Does he accept that in so doing, he will be explicitly going against the positions of the Liberal Democrat candidate in Norwich, South and the leader of the Liberal Democrat group on Norwich city council?

Norman Lamb: One does what one believes in. I have a strongly held view that the decision is wrong and that it is not based on evidence. It would therefore be utterly irresponsible for me, as a parliamentarian, to support the proposal, and I have no hesitation in opposing it.
	I argued at the beginning not that we should sit on the fence, as the hon. Member for South Norfolk (Mr. Bacon) outrageously suggested, but that we should build an agreed way forward for the future of local government, and there is a genuine case for people and civic society in Norfolk contributing to the process in a proper way over a reasonable period. However, the Government were not interested in that. The process that they have pursued is designed to impose change from on high. I appreciate that decisions must be reached, but the process did not involve people locally at all. Excluding the public from the process is utterly outrageous.
	A constitutional convention is now proposed as a way forward for Suffolk because-we are told-there is no consensus, but that is also true in Norfolk. Only 3 per cent. of respondents to the consultation supported the case for a unitary Norwich, and two thirds of voluntary organisations opposed the original proposals for a unitary Norwich, which came from Norwich city council, as did the majority of businesses, a substantial number of town and parish councils, most members of the public, and seven out of eight councils in Norfolk. There is no consensus in support of the proposal.
	Contrary to what the right hon. Member for Norwich, South said, the proposals have profound implications for the rest of Norfolk. The hon. Member for Great Yarmouth (Mr. Wright) made the point that we are creating a council that would mean one-party rule for the rest of Norfolk for ever and a day. Whichever party that is, that is not good for local government or democracy; it is an outrage.
	As I have said, the process should be condemned by everyone. The Government rejected the original proposal for a unitary Norwich on the current boundaries, and yet now, following that lengthy process, we get to the point at which they accept it. How crazy is that?
	My key criticism, as the Liberal Democrat health spokesman, is that three years ago, the Government lauded the fact that they were amalgamating primary care trusts so that we had close to coterminosity between health, social care and children's services. That was a good thing, and it meant better joint working between social services and the NHS. Three years later, as so often happens with this Government, we are moving on again, destroying the arrangement that had been established and creating two organisations to deliver adult social care in Norfolk and two to deliver children's services.
	As I have said, the evidence is that smaller councils do not deliver good-quality services, and my fear is for children's services and services that deliver care for older people if we have a small unitary Norwich alongside the rest of the county. Splitting the two is a wrong decision, and it should be opposed.

Keith Simpson: As the Liberal health spokesman, the hon. Gentleman will know that every report resulting from the brutal death of a child invariably says that one of the most important factors was the duplication of services and nobody taking responsibility. That is what we fear.

Norman Lamb: I absolutely agree with the hon. Gentleman. We must ensure that children's services are robust, and that they are of a scale that enables them to recruit quality officers with the necessary specialisms. To destroy that in the county of Norfolk will put children at risk, which is a disgrace. For all the reasons that I have expressed, I will strongly support the motion tonight, and I will do everything that I can to stop this outrageous decision being implemented.

Gary Streeter: I wish to home in on the two compelling reasons about which we have heard so much in the debate on this important issue, although the Government have not disclosed what evidence lies behind those compelling reasons. The reason why Ministers felt able to depart from the criteria- [ Interruption. ] It is very appropriate that as I am about to speak about the situation in Exeter, the Secretary of State for Culture, Media and Sport, the right hon. Member for Exeter (Mr. Bradshaw) should grace us with his presence.
	The first reason given by the Minister of State is economic regeneration, because, she claims, a unitary Exeter would be a far more potent force for delivering positive outcomes, both for the city and more widely, than the status quo two-tier local government. What is the evidence for that? I asked the Minister that question in an intervention, and she said that when the Exeter city councillors came to see her, they made a very good presentation. But that is not evidence to support the proposition that a unitary Exeter would be better at attracting inward investment and economic regeneration than the situation that has prevailed for many years and has been astonishingly successful over the last few years-the two-tier system of Devon county council and district councils working alongside it.
	I have some experience in this area, because much of the future development land for Exeter lies outside the city boundaries, and in my constituency there is a place called Langage, which is a significant growth point for Plymouth. It is currently virgin land, but it is intended that factories and commercial buildings will be built, creating many thousands of jobs and employing many of my constituents. That site is within Devon county council's area and on South Hams district council land, but it is a growth point for Plymouth. I have attended many meetings with the regional development agency, someone from South Hams, someone from Devon and someone from Plymouth, all trying to reach agreement on the development of that land. As it is intended to be the site for much of Plymouth's growth, it would be better if that land were inside Plymouth city's boundary. My point is that it is much easier to try to make decisions when fewer local authorities are involved.
	The Minister proposes that Exeter should have not two authorities-the county and Exeter district-making decisions, but three local authorities, just as we have on the outskirts of Plymouth. Those will be the unitary Exeter council, Devon county council and whichever district council covers the area. How can that be a more potent force in attracting inward investment and economic regeneration? It simply does not make sense, and it is definitely not a compelling reason. Instead, it is a blind leap of faith.
	We have also heard much about the second so-called compelling reason. The Minister has told us that a unitary Exeter could open the way to improvements in the quality of public services, and she places great store on the whole concept of Total Place. As we understand it, Total Place is all about different agencies and Departments-health, police and local authorities-working together to deliver services to the local community. It is about joined-up thinking, joined-up Government and joined-up delivery of services.
	However, the Minister is now claiming that that can be better achieved by a unitary council, which seems to defeat the purpose of Total Place. If the police, the health authority, councils and other agencies can work together, so can a county council and a district council. It is all part of joined-up thinking and the delivery of services. Citing Total Place as another reason why this decision has been taken in the face of the five prevailing criteria does not make sense. The Minister has gone against the independent boundary committee, against her predecessor's judgment and against the advice of her permanent secretary.
	No wonder the permanent secretary has written such a strong letter, which was read out earlier by my hon. Friend the Member for Bromley and Chislehurst (Robert Neill). It is couched in civil service-speak, but those of us who have been Ministers know exactly what the permanent secretary is saying to the Secretary of State. He is saying, Are you out of your mind? Do not do this, because it will be a disaster. If you proceed, you must instruct me in writing so that I have a get-out when it goes belly up, which it will. He is saying, Don't do this. You're making a huge mistake. We have asked about the evidence, but answer came there none.
	It is instructive and useful to look at what has happened in the rest of Devon and Cornwall in the transition to unitary authority government. My hon. Friend the Member for Tiverton and Honiton (Angela Browning) made a few comments the other day, and in part she is right: it has taken time for Plymouth to settle down as a unitary authority-possibly five years. During those five years, a lot of taxpayers' money was wasted. It is fair to say that it has now settled down as a unitary authority, and is improving and giving good value for money. Torbay is also improving, but it has had its challenges. One reason why it has not really prospered is that, for a unitary authority, it is very much on the small side. Yet Torbay is larger than Exeter, and there is no guarantee that Exeter can deliver the services. Cornwall has recently become a unitary authority, but it is taking a great deal of time to settle down, and the cost was far higher than was ever anticipated.
	I hope that the Under-Secretary of State for Communities and Local Government, the hon. Member for Stevenage (Barbara Follett), in her winding-up speech, will address a point that the Minister did not mention earlier. It is commonly accepted that the transition to a unitary authority in Exeter, if it goes ahead, will cost £25 million. Where will that money come from? It is certainly not in the current coffers of Exeter city council. The proposal is not viable, and flies in the face of common sense.
	Then we come to another point. This decision will not just affect the people of Exeter; it will profoundly affect the people of the rest of Devon. I cannot imagine a Devon county council without its county town-it is like ripping the beating heart out of a living body. It is difficult to anticipate how it will continue to function, and Devon county council estimates that it will cost every council tax payer in Devon £200 per annum more-simply to appease the Government's strange desire to bring about this outcome. It will affect not only the people of Exeter but the people of Devon.
	The Minister might say, You all came to see us to say that you don't want unitary authorities in Devon. Okay, but what is the right way forward? The right way forward is staring us all in the face: co-operation between Devon county council and the district councils, enhanced two-tier status, the sharing of services, the reduction of overheads and working together in partnership, which is happening more and more every year. Devon is becoming an exemplar of how councils can operate together. The Government would have been well advised to leave this all alone. I hope that this proposal will be rejected in another place-and if it is not, I hope that the law courts will throw it out.

Hugo Swire: I think that I find myself in a unique position in the House, in that at the forthcoming election I will be fighting a new seat, and if I am successful, I will have Exeter city council, East Devon district council and Devon county council to look after-and I am perfectly satisfied with that, because they work extremely well together.
	I wish that we were concentrating on making life better for the people of our county. The right hon. Member for Exeter (Mr. Bradshaw), who is here today, knows as well as anyone about the problems facing Bicton college, in my constituency, and Exeter college, in his, and the fiasco over the attempt by the Learning and Skills Council to change the conditions for the hard-earned merger of those two colleges at the last minute. That is a vital issue for East Devon. We should be working together on such matters, rather than mucking around at the 11th hour trying to change and gerrymander boundaries. Nobody wants that.
	In the Prime Minister's amendment, the Government talk about recognising
	the benefits that will accrue to the people of Exeter and Norwich, and to the surrounding areas of Devon and Norfolk,
	but as we have heard during this debate, at no stage has any Minister or, indeed, anyone speaking from the Government Benches, even attempted to outline the methodology, to identify the compelling reasons for change or to show any evidence or business plan-anything that would stand up as evidence in any business situation-to justify the proposed changes.
	In the extraordinary letter that we received from the Under-Secretary of State for Communities and Local Government, the hon. Member for Stevenage (Barbara Follett) this afternoon, headed The Future of Local Service Provision in Devon, she kindly offered to appoint a senior official to act as a champion in Whitehall for all the Devon councils. One can only hope that that would be the old friend of the right hon. Member for Exeter (Mr. Bradshaw), the permanent secretary Mr. Peter Housden, who is so cynical and nervous-and on the record publicly as such-about the entire series of changes.
	We do not think that people in Devon need champions in Whitehall: they have Members of Parliament who are championing them right now, and those seem to be mainly on the Conservative side of the House. At no stage has a Minister accepted that the enhanced two-tier system is working; and, because it does not suit their naked political purposes, at no stage have Ministers said that for East Devon, which is about to share a chief executive and other officers with South Somerset council, the winner in all this will be the East Devon taxpayer. Instead, through political gerrymandering, the Government are trying to appease an existing Cabinet Minister and a past Cabinet Minister-the only two members of the Labour party who are satisfied with what is proposed.
	When we speak about Exeter expanding, I would be grateful if the Under-Secretary of State could share with the House her views on where Exeter is going to expand. Perhaps she could have a quick word with her colleague on her left to identify some areas. If she or any of her colleagues take the trouble to find out, they will find that all the significant growth in the Devon structure plan is outside the city-that is, outside the city today, and outside it even if unitary proposals go ahead for Exeter. The growth is planned to the east of the M5 in my constituency, in Cranbook, a new community of at least 3,000 dwellings, which will include a 30-hectare business park-Skypark-a 25-hectare science park, an inter-modal freight terminal, the expansion of Exeter international airport and a further 500 dwellings in East Devon, an area that covers 315 square miles, and not in Exeter, a city covering 18.5 square miles.
	We are talking about the economic benefits to our city, but it is our county city. I share the view of my hon. Friend the Member for South-West Devon (Mr. Streeter) that to strip out our county city from our county is at best a dereliction of duty, at worst political vandalism. However, to strip out Exeter from the county will not benefit the people of Exeter at this time, and it will manifestly not benefit the rest of the people of Devon either, because as we have heard, there is no provision for additional funding for any restructuring costs incurred by the rest of the county. It will fall to the council tax payers to make up the deficit, and I suspect that a deficit will indeed be incurred in setting up Exeter as a unitary.
	Hon. Members should not take just my word for that. They could perhaps take the words of the leader of the Labour party on Devon county council, who was closely involved for many years with Exeter city council. Councillor Saxon Spence has said in evidence that there is effectively no way that Exeter can be set up as a unitary without central Government support. If the money is available to set up an Exeter unitary, and if we accept that central Government support will be needed, that means, ergo, that there is Government money around somewhere. As a Devon Member of Parliament who is satisfied with the status quo, please may I bid for that money, for my hard-pressed social services, for the survival of Bicton college, the only land-based agricultural college in the south-west, for the potholes in our roads, so that people can get about, or for capping council tax, which our hard-pressed pensioners are finding it increasingly difficult to pay?
	That is not just my view: if Ministers talked to anybody representing a constituency in Devon, from any party other than the Government party, or to any Member of Parliament representing a Norfolk seat, I suspect that they would say the same. However, because this Government have squandered the golden economic legacy that they inherited- [ Laughter. ] The right hon. Member for Exeter laughs, but it is true. Otherwise, why are we in the worst recession that any of us has ever seen or is ever likely to see in our lifetime? At the moment, there is no money to waste on Government schemes to shore up the political careers of two Ministers-or rather, one ex-Minister and one soon-to-be ex-Minister. This proposal should have no place. The Government have run out of time, and it will be a disgrace if they force it through. I pray that when the election eventually comes, the people of Devon will recognise it for what it is.

Chloe Smith: My constituency straddles the boundary of the proposed new Norwich unitary authority and the remainder of Norfolk, covering wards of Norwich city council and Broadland district council. I believe that I have the joy to be part of what the right hon. Member for Norwich, South (Mr. Clarke) has referred to as the trio of affected constituencies.
	I, and about 40 per cent. of my constituents, live in the city of Norwich and, in answer to the point about civic pride made by the right hon. Member for Oxford, East (Mr. Smith), I am very proud to do so. That, however, has zero to do with my stance on the political, financial and ethical aspects of what we are debating. I part company with my city comrade, the right hon. Member for Norwich, South, on his point that only he and I, and the right hon. Member for Exeter (Mr. Bradshaw), have the right to comment on the proposals. Opposition Members have laid out in detail, many times in many different places, the economic, financial, social and political effects of the proposal on the remainder of the county. I suspect that that is as true for Devon as it is for Norfolk.
	Following the point made by my hon. Friend the Member for East Devon (Mr. Swire), I do not hesitate to note the effect of the proposal on the remainder of the country as well. I strongly believe that the proposal on the table in Norwich will be costly and unnecessary, at a time of staggering national budget deficit. When the interest payments on the national debt are greater than the schools budget, it is utterly beyond me to understand why anyone would spend cash on something as unnecessary, unwanted and unreasonable as these proposals.
	The right hon. Member for Norwich, South seems to believe that the debate will be an election winner for him. In case anyone missed his contribution, I must tell them that his dividing lines are probably visible with the naked eye from space. The great majority of my constituents in Norwich, North oppose the proposal. I have barely heard a single positive case being made for it in the street by a citizen of either Norwich city or the Broadland areas that I represent. That is probably on the ground of cost, as well as on the serious grounds of the capability of Norwich city council-of which more in a second-and the lack of democratic consultation on the changes. I agree with the comments made by many hon. Members on that.
	I will limit myself to two points. I shall make a swift point about the double-think surrounding the lack of regard for local people's views during the Government's shambles of a journey to get to this stage. Secondly, I shall examine in slightly more depth the capability of the existing city council to act as a preparing authority and a future guardian for education, social services, and the many other services that others have highlighted.
	On consultation, the Government have ignored the Department for Communities and Local Government's accounting officer. They have also ignored the boundary committee. They have ignored the people, because only 3 per cent. of those who took part in the only consultation available want this proposal for a unitary authority for Norwich on the existing boundaries. They have also ignored hon. Members in this House and in the other place. The point is, however, that they believe that they have consulted and gained support.
	I shall give the House one example of that before I move on to my second point. From the Secretary of State's answer to my question at oral questions this afternoon, I learned that the Government have an indication of support in key places. What is that based on? According to the Secretary of State, it is based on the support of three out of four political parties on Norwich city council, the ambitious authority itself. That is not a broad cross-section of support. As Norwich city council would like to suggest, the proposal has a strong broad cross-section of support, but that is not the same thing.
	The truth is that this Government have failed to hold any kind of individual consultation on the orders for Norwich. The one to which they have had access, conducted by the boundary committee, shows a tiny 3 per cent. in favour of the proposed decision, with 85 per cent. in favour of retaining the status quo-and my constituents agree with that. The huge majority of those constituents who have expressed a view to me have very little faith in the proposed changes delivering anything other than a political fix.
	On the capability of Norwich city council, I share my constituents' delight and pride in living in a fine city. Like them, I hope that we shall soon walk away with the UK city of culture prize. I put it on the record that I congratulate the city council on its work with its partners in getting us this far in the process. I do not slate the council for everything it does, but I do slate it for its record on the delivery of public services so far as my constituents and I, as a resident, are concerned, as there is more at stake than the arts.
	Constituents living in the four wards of Norwich city council that I represent who come to my surgeries with housing problems and wanting to reduce antisocial behaviour, to remove rubbish and to cope with so many other problems, both small and large, have very little faith in the city council's ability-past, present and future-to provide services of a decent quality.

Richard Bacon: They cannot even empty the bins!

Chloe Smith: I thank my hon. Friend for that. The city council is on top of its ability to leave bins full and, as already mentioned, is well known for the failure of its housing department, which led to the Greyhound Opening scandal in 2008-09, in which a senior employee and other staff were allowed to move into decommissioned sheltered housing and rent at social housing rates.

Phyllis Starkey: Will the hon. Lady give way?

Chloe Smith: No, I am afraid not, as I want to make some progress.
	The Audit Commission's report after that scandal awarded the city's services a zero rating and the council is undergoing challenging improvement requirements. This year is the first for five years in which the council's accounts have been officially approved. The city now wishes the new council to focus on
	priorities that will maximise the future economic and social development of the city-
	all well and good-including economic development, co-ordinated growth strategy, educational attainment and aspiration, health improvement, climate change and sustainability, and waste collection and recycling. Those are all laudable, but I note that the competent provision of social housing is explicitly not on that list. For a city authority with a 33 per cent. proportion of social housing, an improvement order and a rock-bottom reputation to overcome, I am concerned.
	Residents of the city area, myself included, do not want new strategy, people and place. They want housing that has no damp climbing the kitchen walls; they want a cashier at city hall who takes honest rent money from honest social tenants, not one who will force people into direct debits, which are very difficult for some people on low incomes to manage, as my constituents have told me; they want a council that answers the phone; and they want low council tax, not a bill for costly reorganisation.
	Put simply, current public services from this city, which wishes to be the preparing authority, is not good enough, and we do not believe that this process will make it better. Why should it have control of the vital areas of education and social services-make-or-break services for the most vulnerable in my constituency-because Labour in Norwich and Whitehall want to expand their political empire?
	I wrap up by observing that much has been made of the democratic deficit by the Labour party in Norwich. It feels in some sense that it is engaged in a David and Goliath struggle against the county council. There is no democratic deficit apart from the one created by this Government and their cronies. There is a deficit because people are ignored. There is a deficit in our national Budget. There is a deficit here in poor public services. That is my concern.

Justine Greening: As we have heard, the history of changing the boundaries and structures of local authorities is long and intricate, but the restructuring in Devon, Norfolk and Suffolk began life back in 2007. As events and tonight's debate have shown, the Government's handling of these proposals has been utterly shambolic and disingenuous.
	We have all heard how councils were asked to make proposals for the formation of unitary government, subject to five criteria that Ministers themselves set. By 2007, the Secretary of State had expressed the view that the unitary proposals for Norwich, Exeter and Ipswich were unlikely to meet all those criteria, but that alternative unitary proposals might. At that point, proposals were referred to the boundary committee. Following legal challenges and delays, as we heard, the boundary committee finally ruled at the end of last year that the city unitary proposals should not be implemented.
	That was not good enough, and Ministers nevertheless chose to press ahead with their city unitary proposals, totally ignoring the boundary committee and what it had said about Norwich and Exeter. Ministers even admit that the city unitary proposals failed to meet the established criteria that they themselves had set for granting unitary status.
	Ministers have argued that additional economic benefits and public service improvements through Total Place would result from the unitary status that they wanted Norwich and Exeter to have. I shall deal with the credibility of those claims shortly, but the simple fact is that Ministers changed the rules governing their own criteria halfway through their game. They may claim that those criteria were not legal requirements set in stone, but they were certainly widely perceived as the basis on which unitary decisions would be made.
	As we heard from my hon. Friend the Member for Bromley and Chislehurst (Robert Neill), the Department's permanent secretary said in his letter to the Secretary of State:
	Whilst there is no statutory basis for the criteria, there is a legitimate expectation that they will be the basis of your decisions.
	The Government ignored that. They are now also subject to legal challenges to the proposals from the county councils involved, and the permanent secretary believes that there is a very high chance that judicial review proceedings would be successful. As we have heard, the Government's handling of the process has been appalling. An additional question is whether there was any valid case for unitary proposals for Exeter and Norwich, and there is overwhelming evidence that that was never the case.
	Did the proposals represent value for money? As my hon. Friend pointed out, the Department's permanent secretary did not think so. He had to write to the Secretary of State requesting a direct instruction to undertake proposals that he considered to be unjustifiable. Commenting on the Secretary of State's view that the economic benefits of city unitaries would offset any additional council running costs, he said:
	The evidence for such gains is mixed and representations that you have received provide no evidence to quantify such benefits.
	The permanent secretary was not alone in expressing concern. The House of Lords Merits Committee was doubtful about Ministers' claims, while Devon and Norfolk county councils criticised the claims about value-for-money savings, also citing a lack of evidence. The money spent on this process could have been channelled into front-line services for the communities affected. It seems that everyone apart from Ministers is unconvinced of the existence of any value-for-money benefits from the unitary proposals for Norwich and Exeter.
	Tonight hon. Members in all parts of the House have repeatedly expressed concern about the proposals and made clear that they are desperately keen for them to be dropped. A future Conservative Government would ensure that that happened. My hon. Friends the Members for South-West Devon (Mr. Streeter) and for East Devon (Mr. Swire) and the hon. Member for North Cornwall (Dan Rogerson) all said that the proposals should be ditched, as indeed they should be.
	Interested parties have been equally scathing about the Government's claim that unitary structures would lead to public service improvements. Both the permanent secretary and the House of Lords Merits Committee felt that there was a distinct lack of evidence for that claim. As we heard from Members representing seats in Norfolk and Norwich, communities there are fundamentally worried about what will happen to their local services if the plan goes ahead. We heard an excellent speech from my hon. Friend the Member for Norwich, North (Chloe Smith). She has not been in the House for many months, but she did a fantastic job in representing her constituents this evening.
	It is bad enough that the Government fudged and then ditched their own criteria, and that they failed to make the case for the new imagined benefits from unitary councils in Norwich and Exeter, but the proposals could have even more damaging effects. As we have heard, they could lead to a rise in council tax across the county of Devon, and we need to see them dropped.
	Once again, however, we have heard from the Minister that she will press ahead with these deeply unpopular measures on the eve of a general election. This decision is born of Ministers' ignorance of everyone. They have ignored the boundary committee, they have ignored the House of Lords Merits Committee, they have ignored their own criteria, they have ignored their own permanent secretary, they have ignored Members of this House, and, most of all, they have ignored members of the public. That is a totally unacceptable way of going about the business of government. The Minister talked about the duty and rights of government, but this Prime Minister has no mandate. It is time for us to vote against this undemocratic measure.

Barbara Follett: This has been a lively and occasionally passionate debate, with feelings running high in all parts of the House. Feelings are running equally high on the ground in Exeter and Devon, in Norwich and Norfolk, and in Suffolk. The proposals have a Marmite-like quality: people either love them or hate them. Tonight we have heard a great deal from those who hate that black fudge kind of stuff.
	We have heard some thoughtful contributions, but most have completely ignored the fact that the proposals have had huge cross-party support in both Norwich and Exeter. People in those proud and ancient cities want, and have wanted for almost half a century, the right to control their own affairs. These proposals are localism carried to its logical conclusion, and I am sorry that Opposition Members cannot see that. Many seem to feel that there is an element of force in the proposals. The hon. Member for North Cornwall (Dan Rogerson) referred to their being rammed through, thus completely ignoring the fact that the boundary committee only reported to the Secretary of State on 23 December, two years after the process had started in 2007. He also ignored the fact that the delay has not been caused by the Government but by expensive and lengthy litigation on the ground, which has led to the timing of the Secretary of State's decision.
	My right hon. Friend the Member for Norwich, South (Mr. Clarke) gave an outline of that expensive and lengthy process, and its background, in a contribution that was both forceful and clear. The hon. Member for North Norfolk (Norman Lamb) flatly contradicted my right hon. Friend's assertion that this was something the people in the area want, feeling that the people of Norfolk had been ignored. As someone who saw the extent of this consultation and who knows that it received 2,800 representations, I simply cannot agree with the hon. Gentleman. Nor can I agree with the hon. Member for North-West Norfolk (Mr. Bellingham) that the creation of a unitary Norwich would not benefit Norfolk. As my hon. Friend the Member for Milton Keynes, South-West (Dr. Starkey) pointed out in her incisive contribution, Buckinghamshire has certainly benefited from the creation of Milton Keynes.
	The hon. Member for East Devon (Mr. Swire) illustrated the non-party-political nature of these decisions. He is against a unitary Exeter, despite the fact that his Conservative colleagues in Exeter are for it and that I saw them. He ignored the fact that until 1974 Exeter was independent of the county council and had been so for 800 years until the Conservatives changed it. We heard from the Opposition that the Labour leader of Devon county council is opposed to unitary change. In Norwich, the unitary proposal is supported by a coalition of Liberal Democrats, the Green party and Labour. In Suffolk, the Conservative leader of the county council strongly supports a unitary county.
	The issues are not simple and it is the task of Government to weigh these matters carefully, to balance competing arguments, to take a wider view in assessing the evidence and differing claims and, finally, to reach a judgment on the best way forward for all concerned. That is exactly what my right hon. Friends in the ministerial team have done and they have done it in the knowledge that before any unitary structure is created, these issues must be fully debated in this House and by another place. They must be agreed here. In the representations today, we have heard graphically from Exeter and Norwich just how the existing system has failed them.
	To conclude-

Patrick McLoughlin: claimed to move the closure (Standing Order No. 36).
	 Question put forthwith , That the Question be now put.
	 Question agreed to.

Question put accordingly (Standing Order No. 31(2)), That the original words stand part of the Question.
	 The House divided: Ayes 191, Noes 275.

Question accordingly negatived.
	 Question put forthwith (Standing Order No. 31(2)), That the proposed words be there added.
	 The House divided: Ayes 267, Noes 185.

Question accordingly agreed to.
	 The Deputy Speaker declared the main Question, as amended, to be agreed to (Standing Order No. 31 (2)).
	 Resolved,
	That this House recognises the benefits that will accrue to the people of Exeter and Norwich, and to the surrounding areas of Devon and Norfolk, from a unitary authority in Exeter and a unitary authority in Norwich; believes that after more than three years of public debate on these issues it is now right for Parliament to consider and finally resolve them; looks forward to debating the draft structural change Orders in the very near future; notes the benefit to local people, including the substantial efficiency savings being achieved, of unitary councils established on 1 April 2009; recognises the wide support for unitary local government in Suffolk; and calls on the councils and right honourable and honourable Members for that county to work quickly together to reach a consensus on a unitary solution for that area.

Business without Debate
	  
	delegated legislation

Motion made, and Question put forthwith (Standing Order No. 118(6)),

Children and Young Persons

That the draft Protection from Tobacco (Sales from Vending Machines) (England) Regulations 2010, which were laid before this House on 27 January, be approved .-(David Wright.)
	 Question agreed to.
	 Motion made, and Question put forthwith (Standing Order No. 118(6)),

Public Health

That the draft Tobacco Advertising and Promotion (Display of Prices) (England) Regulations 2010, which were laid before this House on 27 January, be approved . -(David Wright.)
	 Question agreed to.
	 Motion made, and Question put forthwith (Standing Order No. 118(6)),

Electricity

That the draft Renewables Obligation (Amendment) Order 2010, which was laid before this House on 27 January, be approved . -(David Wright.)
	 Question agreed to.
	 Motion made, and Question put forthwith (Standing Order No. 118(6)),

Social Security

That the draft Social Security (Contributions) (Amendment) Regulations 2010, which were laid before this House on 27 January, be approved . -(David Wright.)
	 Question agreed to.

european Union documents

Motion made, and Question put forthwith (Standing Order No. 119(11)),

Council Decision: Somali Security Forces

That this House takes note of European Union Document No. 5770/10, a Council Decision on a European military mission to contribute to the training of Somali security forces; and welcomes the Council Decision as a positive contribution to building peace and stability in Somalia . -(David Wright.)
	 Question agreed to.

PETITION
	  
	Second Entrance to Higham Ferrers College

Peter Bone: With your permission, Mr. Speaker, I would like to present a petition that has been signed by virtually every resident of Manor way, Duchy close and Queensway in Higham Ferrers.
	The petition states:
	The Humble Petition of residents of Higham Ferrers, Northamptonshire and the surrounding areas,
	Sheweth that there is a massive increase in the volume of pedestrian and vehicular traffic using the Queensway, the one and only access to the Ferrers Specialist Art College, Higham Ferrers; that these circumstances have resulted in significant damage to the grass verges and pathways of the nearby residential estate; and that the Petitioners believe that a secondary entrance to the College via the A6 bypass would considerably alleviate many of the current problems.
	Wherefore your Petitioners pray that your Honourable House urges the Secretary of State for Communities and Local Government to request that Northamptonshire County Council in conjunction with East Northamptonshire District Council and Higham Ferrers Parish council investigates the current problems and introduces a proposal for a second entrance to the Higham Ferrers Specialist Art College.
	And your Petitioners, as in duty bound, will ever pray, c.
	[P000749]

PETROL FILLING STATIONS

Motion made, and Question proposed, That this House do now adjourn. -(David Wright.)

Philip Dunne: I am delighted to have this opportunity to address the House on the subject of business rates as they relate to petrol filling stations. The issue is threatening communities up and down the country, particularly in rural areas. It may be hard at first sight to understand why, and I hope during the debate to make it crystal clear what a damaging proposal the Government are putting forward and the impact that it will have. It will not be apparent immediately, but it is a classic poison pill from this Government for the next Government to inherit.
	I welcome the Under-Secretary of State for Communities and Local Government, the hon. Member for Stevenage (Barbara Follett), who has made herself and her officials available to me and members of the trade associations concerned about the matter in recent weeks. I have to confess that I am a little disappointed that the Economic Secretary to the Treasury is not here to respond, because it is he who has responded to the many letters from MPs on the subject and who has direct responsibility for the Valuation Office Agency, which is the Government agency that is handling the implementation of the business rates revaluation.
	The revaluation takes place every five years and is proving particularly controversial across many sectors this year, not least because the evidence base on which it is being introduced reflects the market conditions prevailing in April 2008-a peak within the commercial property cycle. The revaluation is happening to businesses that are reeling from the twin effects of the recession and the coldest winter in 31 years, which have a direct bearing on petrol filling stations. The Government's arguments about providing real help to business would be more convincing if they were willing to take a pragmatic decision and postpone the revaluation exercise in its entirety because of those problems.

Bill Wiggin: I congratulate my hon. Friend on leading on this subject, which is of exceptional importance to my constituents, particularly David Griffiths, who has seen his business rates go from just over £4,500 to £26,000. My hon. Friend will know that having a car in a rural area is not a luxury; it is a necessity. If our constituents cannot get any petrol, how on earth will they be able to go about their daily lives? I hope that he will get some sensible answers from the Minister, because this is going to be a disaster for rural communities.

Philip Dunne: I am one of my hon. Friend's constituents, and I am glad that he mentions that petrol station, because it was the one that first brought that matter to my attention. It is my local petrol station and the only one within a 10-mile radius on the Shropshire, Herefordshire and Powys borders. If it were to close, it would have a very damaging effect on the rural residents who rely on their motor vehicles to get about, because there is very little public transport along the borders in that remote part of the countryside.
	That 250 per cent. increase in rateable value first brought the matter to my attention. I then undertook a survey of all 15 filling stations in my constituency to find out whether it was an isolated case or a widespread consequence of the revaluation. Eight of the 15 filling stations responded, and half of those-four-indicated that they were looking at increases of between 58 and 250 per cent. in their rateable values. All four said that if that went through, they would have to cut jobs. Two said that they would have to cease selling fuel, and two said that it would put them out of business. The fact that 25 per cent. of the petrol stations in my constituency were likely to cease selling fuel was so significant that I decided to take an interest in the issue, hence my meetings with the Minister.
	The problem is not isolated in rural Shropshire; it is having an impact right across the country. It follows closures of filling stations throughout the past 13 years under this Government.

Stephen Crabb: My hon. Friend is making a powerful case on behalf of rural filling stations. Is he aware that in my constituency in Wales, I have come across filling stations that are looking at business rates increases of more than 300 per cent., and that no transitional rate relief is available to them? As a consequence, numerous filling stations are considering closure in the next few months.

Philip Dunne: My hon. Friend is absolutely right, and I was going to come on to the lack of transitional relief in Wales. More than 111 petrol filling stations in Wales have closed in the past five years. The Welsh Assembly intends to follow the flawed revaluation methodology that I shall come on to in a moment, and it has not agreed any transitional relief, unlike the situation in England. That will pose a particular risk to the remaining 572 petrol stations in Wales, of which 206 are in rural areas and are especially at risk. One of those stations faces an increase in its rateable value not of 300 per cent., as in my hon. Friend's example, but of 725 per cent., which is the largest increase for any petrol station in the United Kingdom. It would be hard to conceive of a Government introducing such a measure while claiming to be providing help to business. Clearly, businesses will have to close if they face that kind of increase.

Geoffrey Clifton-Brown: I congratulate my hon. Friend on raising this very important subject. As I am sure he is aware, petrol stations are unique in that their business rates are calculated not only on the basis of rental value, but on top of that, on assessments of their turnover. That is one reason why they are facing such huge increases. Petrol stations are the only property class that I know of that is assessed in that way. Does my hon. Friend agree that that is grossly unfair? It is grossly unfair on small petrol stations, particularly in rural areas, which are closing as a result. That will mean that there is even less competition, which will mean that prices for our rural constituents will rise.

Philip Dunne: My hon. Friend is absolutely right. He has pre-empted remarks that I was going to make about the palpable lack of equity across the retail estate. It makes no sense at all that a convenience store operating on a forecourt faces a rateable value calculation based on turnover when the convenience store around the corner in the local town or village faces a rateable value calculated only on the size of the premises. The difference is acute-it can mean paying 10 times the amount in rates. I have seen evidence of that, and it is not unusual. Ministers have received letters from hon. Members on both sides of the House to draw that problem to their attention and to ask them for justification, of which, I regret to say, there is none.
	I return to my explanation of the decline in filling stations in the UK since 1997. There were some 5,230 fewer filling stations in the UK at the end of 2009 than at the end of 1997. There are 37 per cent. fewer places to fill up with petrol in England, 39 per cent. fewer in Wales and 22 per cent. fewer in Scotland, or some 250 stations. The pace of those closures has accelerated. In the past five years alone in the west midlands, 30 per cent. of rural petrol stations have closed, which is twice the rate of closure in urban areas.
	Having presided over a dramatic decline in petrol stations throughout the country, the Government have decided to single out the sector for special treatment at the hands of the VOA. For reasons that it has not tried to justify at any point, the VOA has decided to change the methodology for business rates calculations for each of the three different activities that take place on a petrol station forecourt. The VOA is applying that methodology in England and Wales, and assessors in Scotland intend to introduce a new methodology for calculating business rates, but what that will be is entirely opaque at the moment. I shall therefore focus mostly on what is happening in England.
	Before I go into the details of the problems with the methodology, I should say that we are currently facing a spike in petrol prices, which are at record levels. Last weekend, I filled up my vehicle with unleaded petrol and paid 120p a litre. As hon. Members will recall, the last time we paid that much, the hauliers, feeling that their businesses were not viable at that price, threatened to block fuel refineries. Of the 120p a litre we pay today, a 5p increase in February resulted directly from the currency devaluation that we have experienced in the past couple of months, but a further 7p is a consequence of Government increases in duty.
	We had the 2p increase last autumn from the escalator. We had the increase in VAT from 15 per cent. to 17.5 per cent. which added almost 3p a litre to the cost of petrol. Another 1p is going on as a result of the biofuel duty rebate being phased out, and another 1p will go on next month, again as a result of the fuel duty escalator. When those increases are added to the currency changes, it is a 12p increase that is extraneous to the value of oil in the marketplace.
	In responses to Members of Parliament, the Government have tried to justify the change in methodology on the basis that-and I quote the Minister:
	In the last 5 years, alongside rising petrol prices and increasing turnover, the rent paid on many petrol filling stations has grown. It is only fair to all rate payers if this is reflected in rate bills.-[ Official Report, 20 January 2010; Vol. 504, c. 384W.]
	That argument is being used by the VOA to justify an increase in rates. But there is little evidence for that increase in rental value because of the structure of the market, although Ministers and the VOA seem to have difficulty in comprehending that.
	There are now fewer than 9,000 petrol stations in the UK. Roughly 2,000 of those are owned and operated by the major oil companies. Some 1,000 are owned and operated by supermarkets. That leaves about 6,000 that are operated by independents. The rental evidence on which the VOA is relying amounts to some 70 cases that it feels are representative of independent fuel stations. That is less than 1 per cent. of the total of petrol stations and is not a representative sample. The trade associations have not even had an opportunity to assess whether it is a representative sample, even on an anonymised basis to respect commercial confidentiality. One reason why the trade associations argue that it is not representative is that most of the independent filling stations are owner-occupied, so rental premises infrequently come up for renewal or review. When such premises do come up for renewal, a goodwill value is included within the rental value, which is standard practice in the industry but is completely ignored by the VOA. That is why basing all the arguments on rental evidence is fundamentally flawed and I urge the Minister to press the VOA to justify that approach, which does not stand up to independent scrutiny. When the results of the revaluation are challenged in rating appeals, which seems inevitable in view of the scale of the increases, it will be on thin ice when trying to justify the changes.
	The valuation methodology is flawed. As my hon. Friend the Member for Cotswold (Mr. Clifton-Brown) has said, turnover is being used as the primary criterion for calculating rateable value. That approach was introduced in the 2005 valuation, and it has subsequently been further distorted by the 2010 revaluation methodology, which assumes an increased margin on fuel sales. That fails to take into account changing market dynamics, whereby the growth of low-cost supermarket fuel outlets has depressed the profit margins of independent retailers, which has forced them to diversify to stay in business. They have tended to convert their original kiosks into convenience stores. More and more of the space on the forecourt has been made over to convenience stores, because the margins available to the independent sector from selling fuel are substantially lower than they are for the supermarkets or major oil companies. That point is ignored by the VOA when it makes its calculations. It also ignores the fact that the margins on unleaded and diesel differ substantially. I have received evidence suggesting that the margins on unleaded petrol for a typical independent business are roughly double that on diesel, and yet the average for the entire industry is taken by the VOA as appropriate, when clearly it is not. That is another matter that will come out in the rating appeals.
	The average rateable margin from fuel throughput estimated by the VOA is therefore much too high for independent operators, who not only suffer from a lack of purchasing power without any economies of scale, but incur much higher credit costs from suppliers, and higher costs of fuel cards from customers, both of which are not suffered by oil majors or supermarket competitors. It also fails to take into account the higher marketing and distribution costs that independent operators have to pay the oil companies to receive their fuel. That particularly applies in the more peripheral parts of the country, because it obviously costs more to take the fuel longer distances.
	As a result, businesses have tended to diversify, as I have said, into two areas-car washes and convenience stores. The VOA decided in 2010 to change the basis for calculating rates on car washes. In 2005 that became a percentage of turnover, and was based on a banding system averaging 16 per cent. of turnover across the industry. The VOA has decided that that should be increased to 20 per cent., without a banding system. It has increased arbitrarily, and without justification, the percentage of turnover to which rates should apply.
	Car wash businesses are regulated, so have the added cost of compliance with environmental legislation, but their competitors down the road, operating hand car washes-often in supermarket car parks and other places-are not regulated or subject to rates, which means that they can undercut the car wash businesses on the forecourts. Consequently, car wash revenues have declined in recent years as the hand car washes have proliferated.
	The second area of diversification has been convenience stores, on which, as my hon. Friend the Member for Cotswold made clear, turnover is the basis of calculation. There is no reflection of the size of the premises in the 2010 revaluation. Instead, the calculation is based on increasing bands of turnover, capped at £2 million. Of course, that is of considerable benefit to supermarkets with petrol stations adjacent to their car parks, because invariably their turnover is much higher than £2 million, which means that they are not subject to the same rates. They have a protection not available to small independent businesses. The valuation based on turnover gives rise to rateable values much higher than those applying to other convenience stores trading around the corner, which are subject to valuation based on area. The VOA has made no attempts to justify those changes in its methodologies, and is relying entirely on evidence that, as I have said already, is not representative.
	I now turn to the impact of the changes. In answer to a parliamentary question from my hon. Friend the Member for Mole Valley (Sir Paul Beresford), the Government admitted that more than 3,000 petrol filling stations in England-a third of the total-are facing an increase in their rateable values of more than 50 per cent. Half of them, 1,510, to be precise, are facing increases of more than 100 per cent.-double the rateable value-this year. I have come across one business facing an increase of 450 per cent., and I have referred to another in Wales that is facing an increase of 725 per cent.
	The significance in my constituency, as I have said, is that several operators in rural areas are likely to cease selling fuel. Some of them, including my own local garage, which was referred to by my hon. Friend the Member for Leominster (Bill Wiggin), regard the sale of fuel as a social service for the community. Mine is hardly making money out of it, but providing the service to attract people to the shop. It is a long-standing activity that the proprietor recognises is vital to the local area.
	The Valuation Office Agency is beginning to realise that a problem is brewing, and not just in the level of appeals. It is also aware that the situation will lead to significant closures. In fact, the official from the VOA in the west midlands has told one proprietor in my area that if the revaluation goes through, the economically logical conclusion would be to stop selling fuel. Not only would that lead to a significant reduction in the Government's income from rates based on fuel sales, but the rates on the residual shop businesses would revert to a normal area basis, and therefore be significantly lower, which would be self-defeating for the VOA.
	Another petrol station-this is my final point-has already had an approach from the VOA to halve its proposed increase. Will the Minister say whether that is an isolated case? Does the VOA know that it has made a mistake, and is it therefore seeking to negotiate deals? If so, how many deals is it negotiating? Does the Minister accept that that is a methodology that has to change?
	Having said that that was my final point, I have one more point to make, picking up on the point about transitional relief-if you will indulge me, Mr. Speaker. The Minister and the VOA are hiding behind transitional relief. They have put a cap of 11 per cent. on the increase in the cash cost of rates to businesses, but we have examples of petrol stations facing much larger increases in the first year, and it is no coincidence that transitional relief applies in this, an election year. The escalation of rateable value increases kicks in faster in subsequent years, with increases of 25 per cent. a year in the final two years of the five-year transitional scheme-a legacy that is a classic Gordon Brown poison pill for an incoming Government. The large tax rises will occur in two to four years, so closures are most likely to fall on the next Government's watch.

Barbara Follett: I congratulate the hon. Member for Ludlow (Mr. Dunne) on securing this evening's debate, and thank him for raising some important points about how petrol filling stations are rated and the methodology behind that rating, particularly as part of the rating revaluation for 2010. I also thank the hon. Members for Cotswold (Mr. Clifton-Brown), for Leominster (Bill Wiggin) and for Preseli Pembrokeshire (Mr. Crabb) for raising other points, which I have noted.
	As the hon. Member for Ludlow knows, the detail of how petrol filling stations are rated is extremely complex, so if he will permit me, I should like to run through how the business rates system, and revaluations, operate. The business rates system, which has been in its current form since 1990, is designed to ensure that the burden of this tax is equitably distributed across all non-domestic ratepayers. It is estimated that business rates will raise £21 billion in 2009-10. All that revenue goes back to fund local government services such as education, planning and transport.
	Business rates are a tax on property that is capable of beneficial occupation, and they are mainly based on the hypothetical rent that a property could attract at a specific point in time. In this year's revaluation, that point in time is a problem. The better the location, or the better the amenities that a property provides, the greater the rent that it could attract. That is reflected in the increased rates that a business is liable to pay. As the hon. Gentleman knows well, the calculation of business rates liability is based on the rateable value multiplied by a figure linked to annual inflation based on the retail prices index, which is negative for 2010-11; that reduces rates liabilities somewhat.
	The hon. Gentleman asked why we did not defer the revaluation, but regular revaluations are an important part of the rating system, as they help to maintain fairness by rebalancing the burden within the overall envelope. If we were to defer the revaluation, as he has suggested, that would hit some businesses that are doing much less well. It is a redistribution, and I do understand that it will involve winners and losers. The hon. Gentleman has spoken eloquently tonight about some of the losers. The next revaluation will take effect from 1 April 2010, and it will be based on rental values at 1 April 2008. The property market has changed a great deal since April 2008, but the multiplier has been brought down to its lowest level in 17 years to try to iron that out.
	Rates liability and rateable value are not the same thing, as the hon. Gentleman knows. Rateable values can rise, but rates liability is capped by the transitional relief scheme, which, despite what he says, is not a Gordon Brown scheme. It is built in. The scheme-which, sadly, is not available in Wales-has been built in to try to cap the rises, which can be steep in the areas where there are losers; they are not particularly steep in the areas where there are winners. Smaller businesses will see their rates capped at 3.5 per cent., and larger businesses at 11 per cent. That relief will help about 500,000 business properties with their rates liabilities in 2010-11.

Geoffrey Clifton-Brown: Will the Minister give way?

Barbara Follett: If the hon. Gentleman will forgive me, I will not. I have only three minutes left, and I am worried that I will not fit everything in. I apologise, especially as I am already a disappointment for not being a Treasury Minister.
	On petrol filling stations, I understand exactly the concerns expressed by the hon. Member for Ludlow about the Valuation Office Agency's methodology, and I will explore that matter in more detail with the Treasury, and perhaps with the hon. Gentleman himself. It is important to note that the Valuation Office Agency does not set the method, but follows industry practices. It has engaged with bodies such as the United Kingdom Petroleum Industry Association to gain a better understanding of the petrol filling station market.
	The Valuation Office Agency examined 1,300 rents for petrol filling stations. Although some of those rents were from oil companies and sites run by hypermarkets, many related to independent and rural sites. The agency has analysed the information on rents by reference to the throughput found at petrol stations. I should like to tell the hon. Member for Cotswold that throughput is used because we believe that it is a better guide to value than size, and this is the practice of the petrol filling station market. This approach is not new, and it reflects actual practice in the market when private sector surveyors negotiate rents for petrol filling stations. Some petrol filling stations will face increases in rateable values, thanks to rises in rents. However, the revaluation will also ensure that 960 petrol filling stations will receive reductions in their rates liabilities.
	It is right that the Valuation Office Agency should assess rateable values independently, because that maintains fairness and transparency in the rating system. That is why Ministers do not intervene. There is an appeals system which provides the appropriate avenue for any sector-
	 House adjourned without Question put (Standing Order No. 9(7)).